Document Name

Information Type

Recipients

Timing

Annual Report – Form 5500 series

-Filing based on determination of number of participants at beginning of plan year.

-Not required for plans with fewer than 100 participants that are fully insured, unfunded (paid directly from employer’s general assets), or combination of both.

-Required for plans with 100 or more participants.

-Required for plans with fewer than 100 participants if funded through a VEBA trust.

-Submitted to DOL’s EBSA;

-Shared with IRS;

-Schedule SSA (a portion of the Form) shared with the Social Security Administration.

-Due on the last day of the 7th month following the close of the plan year or short plan year;

-May request one time 2 ½ month extension if requested before normal filing due date;

-Automatic extension until due date of employer’s federal tax return if all of the following are met:

• plan year and employer’s tax year are same; and

• employer has been granted extension to file federal tax return beyond normal due date of Form 5500 filing.

Summary Plan Description (SPD)

-Principle means of informing participants and beneficiaries about the features and operations of their plan.

-Must be written in a manner that an average participant can comprehend.

-Must be sufficiently comprehensive to apprise covered persons of their benefits, rights, and obligations under the plan.

-Must accurately portray the plan’s contents as of the date not earlier than 120 days prior to the date the SPD is disclosed.

-Participants and plan beneficiaries receiving benefits. (See “Plan Documents” for requirement to produce upon request).

-Foreign language assistance may be required when the percentage of participants that are literate only in the same non-English language crosses a certain threshold.
 

-Automatically due to participants within 90 days of becoming covered by the plan.

-A plan is given 120 days after becoming subject to ERISA to distribute the SPD.

-If changes are made or plan is amended, updated SPDs must be furnished every 5 years.

-Otherwise, if no changes or amendments, must be furnished every 10 years.

Summary of Material Modification (SMM)

-Describes “material modifications” implemented within a plan and any changes in the information required to be in the SPD.

-Distributing updated SPD satisfies this requirement.

-Participants and plan beneficiaries receiving benefits. (See “Plan Documents” below for requirement to produce upon request).

-Automatically due to participants and plan beneficiaries receiving benefits when “material modifications” implemented

-Not later than 210 days after the end of the plan year in which the change is adopted.

Summary Annual Report (SAR)

-Summary of the Form 5500 in a narrative format.

-Participants and plan beneficiaries receiving benefits.

-Automatically due to participants and plan beneficiaries receiving benefits within 9 months after the end of a plan year (or 2 months after due date for filing Form 5500, with approval extension).

Claim Procedure Notices

-Information on procedures for handling claims for benefits by participants or beneficiaries and for allowing and deciding appeals of denied claims.

-It must address, among other issues:

• claims filing
• denial notices
• provision of other information
• appeal rights

-Participants and beneficiaries.

-Generally included in the SPD for distribution. Also distributed in response to a written request from participants and beneficiaries.

Notification of Benefit Determination (claims notices or “Explanation of Benefits”)

-Information concerning determination of benefit claims.

-Required disclosures must be included for any adverse benefit determinations (e.g., the specific reason(s) for the denial of a claim, reference to the specific plan provisions on which the benefit determination is based, and a description of the plan’s appeal procedures).

-Claimants (participants and/or beneficiaries or authorized claims representatives).

-Various requirements depending on type of plan and the benefit claim involved.

-See 29 CFR § 2560.503-1 for prescribed claims procedures requirements.

Plan Documents

-Copies must be furnished by the plan administrator upon written request, and

-Copies must be made available for examination.

-Documents to be made available include the latest updated SPD, latest Form 5500, trust agreement, and other instruments under which the plan is established or operated.

-Participants and beneficiaries.

-Within 30 days of receiving a written request, copies must be furnished.

-In addition to its principal office, ERISA regulations specify the location at which the Plan administrator must make copies available.