ERISA is a federal law that deals with employee benefit plans, including group health insurance. Among other things, ERISA law defines the way in which benefit plan information must be shared with plan participants (employees). The vehicle for sharing that information is called a Plan Document.
Who is subject to ERISA?
With few exceptions, all private sector corporations and partnerships, including non-profits, must comply with ERISA regardless of their size or number of employees. Which means that any company offering group health insurance (or other plans subject to ERISA) must have an ERISA-compliant Plan Document in place. (Note that this is different from the Form 5500 filing requirement, which comes into play when a plan has more than 100 participants.)
Does your medical insurance carrier provide a Plan Document?
Yes, but only for the medical insurance plan, not for the overall employer plan. None of these documents constitutes a Plan Document as required under ERISA:
- Master Contract from an insurance carrier
- Certificate of Coverage
- Summary of Benefits
- Cafeteria Plan Document (aka Section 125 or POP)
A written contract of insurance with an insurance company does not normally contain all of the rules required by ERISA and is therefore not a Plan Document.
So, if you are an employer of any size and you are providing group health insurance, you absolutely need an ERISA-compliant Plan Document for your benefit plan.
Up next: what an ERISA-compliant Plan Document contains.