faster SPD Wrap Document

Component Plan Documents

Required Attachments
Depending on available information from your providers and the requirements listed below, attach one or more of the following documents to your SPD Wrap for each group benefit:

• Participant Insurance Rates, and if applicable, any special age banded or years of service contribution rates (unless previously distributed to participants); and
• Certificates of insurance; or
• Insurance booklets, brochures, or benefits summary; and/or
• Group Insurance Contracts.

Required Insurance Coverage Details
This information should be covered in one or more of the documents listed above.

• Summary of benefits or benefits schedules;
• Cost sharing provisions (premiums, deductibles, coinsurance and copays);
• Detailed description of plan provisions, coverage, limitations and exclusions, such as lifetime caps or limitations; preventative services; drug coverage; medical tests; devices and procedures; provisions governing use of network providers; coverage for out of network services; limitations on coverage of out of network services; emergency services; specialty medical care; and pre-authorization requirements;
• Statement identifying circumstances which may result in disqualification, ineligibility, denial, loss, forfeiture or suspension of coverage;
• Network provider general description and where to access provider information; or
• Claims procedures and pre-authorization requirements.

Translation Assistance

As the plan administrator you have a requirement to provide translation assistance to participating employees upon request if:

• Your plan covers fewer than 100 participants at the beginning of a plan year and has 25 percent or more of plan participants who are literate only in the same non-English language;
• Your plan covers 100 or more participants at the beginning of the plan year and 10% or more of all plan participants; or
• 500 or more participants (whichever is less) are literate only in the same non-English language.

Documentation

Distribution
Be prepared to prove you furnished the SPD Wrap Document and component plan information (or the SMM) to participants in a way reasonably calculated to ensure actual receipt, retaining evidence of the notice being given, including:

• A copy of the notice;
• The date it was provided; and
• To whom it was provided.

Records
The faster system maintains data for all documents created through WrapXpress. This allows you to re-enter the system any time to edit and generate a new document. Any special document customizations or edits made to your documents must be recorded and maintained by your company.

Updates
Keep information current by updating the information in WrapXpress any time there are changes. Plan changes must be communicated with a Summary of Material Modifications (SMM) notice or an updated SPD (both available in WrapXpress).