Your benefits guide is not your plan document.
Most employers have a benefits guide, a stack of carrier certificates, and no Summary Plan Description. ERISA requires the third one, and it is the first document an investigator asks to see. Here is the difference, why the gap is so common, and the ordinary fix.
One of them is required by law.
They overlap enough to be confused and differ enough to matter.
The benefits guide
An enrollment communication. Plans, tiers, costs, carrier contacts, how to enroll. Useful, well designed, and not required by ERISA.
Its own disclaimer usually says the text was drawn from various summary plan descriptions and that the actual plan documents prevail. That sentence is correct — and it is also the tell that the guide is not the plan document.
The Summary Plan Description
A legal disclosure document with prescribed contents, furnished on a clock, and the first thing a Department of Labor investigator asks for.
It explains the plan in plain language: who administers it, who to sue, how to claim, how to appeal, and what rights participants have if any of that goes wrong.
The carrier certificate is not one either.
Fully insured employers usually have a certificate of coverage from the carrier and reasonably assume that is the plan document. It is not. It describes the insurance, which is only part of what ERISA asks for.
What the certificate leaves out is everything around the insurance: the plan administrator, the agent for service of legal process, the plan number, the claims and appeals procedure, and the Statement of ERISA Rights.
The ordinary remedy is a wrap document. A wrap SPD sits around the carrier certificates and adds the content ERISA requires. It is routine plan housekeeping rather than an emergency, and it is what most employers in this position are actually missing.
What a Summary Plan Description has to contain.
Required content for a group health plan under 29 CFR 2520.102-3. Run it against whatever your organization currently treats as its plan document.
Identifying the plan
The plan name and any name it is commonly known by. The sponsor’s name and address. The employer identification number and the plan number. The type of plan and how it is administered. The plan administrator’s name, business address and telephone number. The name and address of the agent for service of legal process.
The benefits and the money
Eligibility conditions and a description of the benefits. Cost sharing — premiums, deductibles, coinsurance, copays and any caps. Network composition and how out-of-network coverage works. Preauthorization and utilization review requirements. The source of contributions and how they are calculated.
Rights and procedure
The circumstances that cause denial, loss or forfeiture of benefits. Claims procedures, including appeals. COBRA continuation rights and obligations. The Newborns’ and Mothers’ Act hospital length-of-stay statement. The Statement of ERISA Rights. The plan year end, and the sponsor’s right to amend or terminate.
The clock most employers miss.
90 days
After an employee becomes a participant, the SPD has to be furnished to them. Not made available on request — furnished.
120 days
For a plan newly subject to ERISA, counted from the day it becomes subject.
5 or 10 years
An updated SPD is due within 210 days after the plan year ending five years after the last material change — or ten years if the plan has not been amended at all.
The half that gets forgotten is delivery. An SPD sitting in a drawer has not been furnished, and a plan administrator who cannot say how and when it reached participants is in the same position as one that never wrote it.
The fastest way to check what you have
Search your plan document for the phrase “agent for service of legal process” and for the Statement of ERISA Rights. A carrier certificate almost never contains either. If both are missing, what you are holding is not a Summary Plan Description, and nothing else on the list above needs checking.
This is general information and not legal advice. The requirements above come from the Department of Labor’s regulations at 29 CFR 2520.102-3 and 2520.104b-2.
What employers ask us about plan documents.
The same ten questions, in the order they usually arrive.
Is our benefits guide the same thing as an SPD?
No. The benefits guide is an enrollment communication. The Summary Plan Description is a disclosure document ERISA requires, with contents set by regulation. Most guides say as much in their own disclaimer — that the text was drawn from summary plan descriptions and that the plan documents prevail.
Isn’t the carrier’s certificate of coverage our plan document?
Not by itself. A certificate describes the insurance. It rarely names the plan administrator or the agent for service of legal process, and it almost never carries the plan number, the ERISA claims and appeals procedure or the Statement of ERISA Rights.
What is a wrap document?
A short document that wraps around the carrier certificates and adds the ERISA content they are missing. The certificates and the wrap together become the SPD. It is drafted work — we coordinate it through an ERISA attorney rather than assembling one out of your benefits guide.
We have twelve employees. Are we too small for this?
No. ERISA applies to private-sector employers regardless of size, and there is no small-group exemption from the SPD. The relief employers usually have in mind is the Form 5500 filing exemption for small insured or unfunded plans, which is a different obligation. Church and governmental plans sit outside ERISA entirely.
Whose job is it — ours, the carrier’s, or our broker’s?
The plan administrator’s, and unless the plan document names someone else, the plan administrator is the employer. A carrier furnishes its certificate; it does not furnish your SPD. A broker can coordinate the work, and should, but the obligation stays with the employer.
When does it have to go out?
Within 90 days of an employee becoming covered, and within 120 days of a plan first becoming subject to ERISA. After that, a restated SPD is due within 210 days after the plan year ending five years from the last material change — ten years if the plan has not been amended at all.
Can we just post it on the intranet?
Posting is not furnishing. Electronic delivery works under the 2002 safe harbor for employees who use a computer as an integral part of the job, and for everyone else with their affirmative consent. Either way you owe them notice of what the document is, a paper copy on request, and a way to confirm it arrived. The Department of Labor proposed a broader notice-and-access rule for group health plans in July 2026; until that is final, the 2002 rule governs.
We changed the plan mid-year. Does that need anything?
A Summary of Material Modifications, due within 210 days after the close of the plan year in which the change was adopted. A material reduction in covered services or benefits under a group health plan moves faster than that: 60 days from adoption.
An employee asked for ours in writing and we do not have one.
The plan administrator has 30 days to respond. After that a court may assess up to $110 a day against the plan administrator, and the clock runs from the thirty-first day rather than from the audit.
Does it have to be in another language?
Sometimes. Where 25 percent or more of participants in a plan with fewer than 100 participants — or the lesser of 500 participants or 10 percent in a larger plan — are literate only in the same non-English language, the SPD must carry a prominent notice in that language offering assistance, and that assistance has to be real.
General information about ERISA’s disclosure rules, not legal advice. Plan-specific questions belong with ERISA counsel, and we will bring them in.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
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