UGS Summary Plan Description


Reference

 

The Plan Document/Summary Plan Description (PD/SPD) is one of the most important documents participants are entitled to receive when becoming a participant of an ERISA-covered health benefit plan.  The PD/SPD tells participants what the plan provides and how it operates. It provides information on when an employee can begin to participate in the plan, how service and benefits are calculated, when and in what form benefits are paid, and how to file a claim for benefits. If a plan is changed, participants must be informed through a plan amendment.

Content

The PD/SPD must be written for the average participant and be sufficiently comprehensive to apprise covered persons of their benefits, rights, and obligations under the plan. 

The PD/SPD must accurately reflect the plan’s contents as of the date not earlier than 120 days prior to the date the PD/SPD is disclosed.

The PD/SPD must contain the following information:

Additional Content Required for Group Health Plans:

Non-English Language

Under certain circumstances, the PD/SPD and plan amendments must state an offer of assistance in a non-English language.

This assistance must be calculated to provide participants a reasonable opportunity to become informed as to their rights and obligations under the plan.

If applicable, this offer of assistance (written in the non-English language) should appear at the beginning of the PD/SPD or plan amendment or on its cover.

The obligation for providing this assistance applies to:

Material Modifications

The Plan Amendment describes material modifications to a plan and changes in the information required to be in the PD/SPD. 

Noncompliance

Failure to Comply with Content or Format Rules

If a PD/SPD is not compliant with the PD/SPD content or format rules, an employer may leave itself liable for:

Failure to Prepare or Supply an PD/SPD

Additional Resources

Department of Labor Web Site