Section 102 of the Act specifies information that must be included
in the summary plan description. The summary plan description must
accurately reflect the contents of the plans as of the date not earlier
than 120 days prior to the date such summary plan description is
disclosed. The following information shall be included in the summary
plan description of both employee welfare benefit plans and employee
pension benefit plans, except as stated otherwise in paragraphs (j)
through (n):
(a) The name of the plan, and, if different, the name by which the
plan is commonly known by its participants and beneficiaries;
(b) The name and address of--
(1) In the case of a single employer plan, the employer whose
employees are covered by the plan,
(2) In the case of a plan maintained by an employee organization for
its members, the employee organization that maintains the plan,
(3) In the case of a collectively-bargained plan established or
maintained by one or more employers and one or more employee
organizations, the association, committee, joint board of trustees,
parent or most significantly employer of a group of employers all of
which contribute to the same plan, or other similar representative of
the parties who established or maintain the plan, as well as
(i) A statement that a complete list of the employers and employee
organizations sponsoring the plan may be obtained by participants and
beneficiaries upon written request to the plan administrator, and is
available for examination by participants and beneficiaries, as required
by Sec. Sec. 2520.104b-1 and 2520.104b-30; or
(ii) A statement that participants and beneficiaries may receive
from the plan administrator, upon written request, information as to
whether a particular employer or employee organization is a sponsor of
the plan and, if the employer or employee organization is a plan
sponsor, the sponsor's address.
(4) In the case of a plan established or maintained by two or more
employers, the association, committee, joint board of trustees, parent
or most significant employer of a group of employers all of which
contribute to the same plan, or other similar representative of the
parties who established or maintain the plan, as well as
(i) A statement that a complete list of the employers sponsoring the
plan may be obtained by participants and beneficiaries upon written
request to the plan administrator, and is available for examination by
participants and beneficiaries, as required by Sec. Sec. 2520.104b-1
and 2520.104b-30, or,
(ii) A statement that participants and beneficiaries may receive
from the plan administrator, upon written request, information as to
whether a particular employer is a sponsor of the plan and, if the
employer is a plan sponsor, the sponsor's address.
(c) The employer identification number (EIN) assigned by the
Internal Revenue Service to the plan sponsor and the plan number
assigned by the plan sponsor. (For further detailed explanation, see the
instructions to the plan description Form EBS-1 and ``Identification
Numbers Under ERISA'' (Publ. 1004), published jointly by DOL, IRS, and
PBGC);
(d) The type of pension or welfare plan, e.g. pension plans--defined
benefit, defined contribution, 401(k), cash balance, money purchase,
profit sharing, ERISA section 404(c) plan, etc., and for welfare plans--
group health plans, disability, pre-paid legal services, etc.
(e) The type of administration of the plan, e.g., contract
administration, insurer administration, etc.;
(f) The name, business address and business telephone number of the
plan administrator as that term is defined by section 3(16) of the Act;
(g) The name of the person designated as agent for service of legal
process, and the address at which process may be served on such person,
and in addition, a statement that service of legal process may be made
upon a plan trustee or the plan administrator;
(h) The name, title and address of the principal place of business
of each trustee of the plan;
(i) If a plan is maintained pursuant to one or more collective
bargaining agreements, a statement that the plan
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is so maintained, and that a copy of any such agreement may be obtained
by participants and beneficiaries upon written request to the plan
administrator, and is available for examination by participants and
beneficiaries, as required by Sec. Sec. 2520.104b-1 and 2520.104b-30.
For the purpose of this paragraph, a plan is maintained pursuant to a
collective bargaining agreement if such agreement controls any duties,
rights or benefits under the plan, even though such agreement has been
superseded in part for other purposes;
(j) The plan's requirements respecting eligibility for participation
and for benefits. The summary plan description shall describe the plan's
provisions relating to eligibility to participate in the plan and the
information identified in paragraphs (j)(1), (2) and (3) of this
section, as appropriate.
(1) For employee pension benefit plans, it shall also include a
statement describing the plan's normal retirement age, as that term is
defined in section 3(24) of the Act, and a statement describing any
other conditions which must be met before a participant will be eligible
to receive benefits. Such plan benefits shall be described or
summarized. In addition, the summary plan description shall include a
description of the procedures governing qualified domestic relations
order (QDRO) determinations or a statement indicating that participants
and beneficiaries can obtain, without charge, a copy of such procedures
from the plan administrator.
(2) For employee welfare benefit plans, it shall also include a
statement of the conditions pertaining to eligibility to receive
benefits, and a description or summary of the benefits. In the case of a
welfare plan providing extensive schedules of benefits (a group health
plan, for example), only a general description of such benefits is
required if reference is made to detailed schedules of benefits which
are available without cost to any participant or beneficiary who so
requests. In addition, the summary plan description shall include a
description of the procedures governing qualified medical child support
order (QMCSO) determinations or a statement indicating that participants
and beneficiaries can obtain, without charge, a copy of such procedures
from the plan administrator.
(3) For employee welfare benefit plans that are group health plans,
as defined in section 733(a)(1) of the Act, the summary plan description
shall include a description of: any cost-sharing provisions, including
premiums, deductibles, coinsurance, and copayment amounts for which the
participant or beneficiary will be responsible; any annual or lifetime
caps or other limits on benefits under the plan; the extent to which
preventive services are covered under the plan; whether, and under what
circumstances, existing and new drugs are covered under the plan;
whether, and under what circumstances, coverage is provided for medical
tests, devices and procedures; provisions governing the use of network
providers, the composition of the provider network, and whether, and
under what circumstances, coverage is provided for out-of-network
services; any conditions or limits on the selection of primary care
providers or providers of speciality medical care; any conditions or
limits applicable to obtaining emergency medical care; and any
provisions requiring preauthorizations or utilization review as a
condition to obtaining a benefit or service under the plan. In the case
of plans with provider networks, the listing of providers may be
furnished as a separate document that accompanies the plan's SPD,
provided that the summary plan description contains a general
description of the provider network and provided further that the SPD
contains a statement that provider lists are furnished automatically,
without charge, as a separate document.
(k) In the case of an employee pension benefit plan, a statement
describing any joint and survivor benefits provided under the plan,
including any requirement that an election be made as a condition to
select or reject the joint and survivor annuity;
(l) For both pension and welfare benefit plans, a statement clearly
identifying circumstances which may result in disqualification,
ineligibility, or denial, loss, forfeiture, suspension, offset,
reduction, or recovery (e.g., by exercise of subrogation or
reimbursement
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rights) of any benefits that a participant or beneficiary might
otherwise reasonably expect the plan to provide on the basis of the
description of benefits required by paragraphs (j) and (k) of this
section. In addition to other required information, plans must include a
summary of any plan provisions governing the authority of the plan
sponsors or others to terminate the plan or amend or eliminate benefits
under the plan and the circumstances, if any, under which the plan may
be terminated or benefits may be amended or eliminated; a summary of any
plan provisions governing the benefits, rights and obligations of
participants and beneficiaries under the plan on termination of the plan
or amendment or elimination of benefits under the plan, including, in
the case of an employee pension benefit plan, a summary of any
provisions relating to the accrual and the vesting of pension benefits
under the plan upon termination; and a summary of any plan provisions
governing the allocation and disposition of assets of the plan upon
termination. Plans also shall include a summary of any provisions that
may result in the imposition of a fee or charge on a participant or
beneficiary, or on an individual account thereof, the payment of which
is a condition to the receipt of benefits under the plan. The foregoing
summaries shall be disclosed in accordance with the requirements under
29 CFR 2520.102-2(b).
(m) For an employee pension benefit plan the following information:
(1) If the benefits of the plan are not insured under title IV of
the Act, a statement of this fact, and reason for the lack of insurance;
and
(2) If the benefits of the plan are insured under title IV of the
Act, a statement of this fact, a summary of the pension benefit guaranty
provisions of title IV, and a statement indicating that further
information on the provisions of title IV can be obtained from the plan
administrator or the Pension Benefit Guaranty Corporation. The address
of the PBGC shall be provided.
(3) A summary plan description for a single-employer plan will be
deemed to comply with paragraph (m)(2) of this section if it includes
the following statement:
Your pension benefits under this plan are insured by the Pension
Benefit Guaranty Corporation (PBGC), a federal insurance agency. If the
plan terminates (ends) without enough money to pay all benefits, the
PBGC will step in to pay pension benefits. Most people receive all of
the pension benefits they would have received under their plan, but some
people may lose certain benefits.
The PBGC guarantee generally covers: (1) Normal and early retirement
benefits; (2) disability benefits if you become disabled before the plan
terminates; and (3) certain benefits for your survivors.
The PBGC guarantee generally does not cover: (1) Benefits greater
than the maximum guaranteed amount set by law for the year in which the
plan terminates; (2) some or all of benefit increases and new benefits
based on plan provisions that have been in place for fewer than 5 years
at the time the plan terminates; (3) benefits that are not vested
because you have not worked long enough for the company; (4) benefits
for which you have not met all of the requirements at the time the plan
terminates; (5) certain early retirement payments (such as supplemental
benefits that stop when you become eligible for Social Security) that
result in an early retirement monthly benefit greater than your monthly
benefit at the plan's normal retirement age; and (6) non-pension
benefits, such as health insurance, life insurance, certain death
benefits, vacation pay, and severance pay.
Even if certain of your benefits are not guaranteed, you still may
receive some of those benefits from the PBGC depending on how much money
your plan has and on how much the PBGC collects from employers.
For more information about the PBGC and the benefits it guarantees,
ask your plan administrator or contact the PBGC's Technical Assistance
Division, 1200 K Street N.W., Suite 930, Washington, D.C. 20005-4026 or
call 202-326-4000 (not a toll-free number). TTY/TDD users may call the
federal relay service toll-free at 1-800-877-8339 and ask to be
connected to 202-326-4000. Additional information about the PBGC's
pension insurance program is available through the PBGC's website on the
Internet at http://www.pbgc.gov.
(4) A summary plan description for a multiemployer plan will be
deemed to comply with paragraph (m)(2) of this section if it includes
the following statement:
Your pension benefits under this multiemployer plan are insured by
the Pension Benefit Guaranty Corporation (PBGC), a federal insurance
agency. A multiemployer plan is a collectively bargained pension
arrangement involving two or more unrelated employers, usually in a
common industry.
[[Page 397]]
Under the multiemployer plan program, the PBGC provides financial
assistance through loans to plans that are insolvent. A multiemployer
plan is considered insolvent if the plan is unable to pay benefits (at
least equal to the PBGC's guaranteed benefit limit) when due.
The maximum benefit that the PBGC guarantees is set by law. Under
the multiemployer program, the PBGC guarantee equals a participant's
years of service multiplied by (1) 100% of the first $5 of the monthly
benefit accrual rate and (2) 75% of the next $15. The PBGC's maximum
guarantee limit is $16.25 per month times a participant's years of
service. For example, the maximum annual guarantee for a retiree with 30
years of service would be $5,850.
The PBGC guarantee generally covers: (1) Normal and early retirement
benefits; (2) disability benefits if you become disabled before the plan
becomes insolvent; and (3) certain benefits for your survivors.
The PBGC guarantee generally does not cover: (1) Benefits greater
than the maximum guaranteed amount set by law; (2) benefit increases and
new benefits based on plan provisions that have been in place for fewer
than 5 years at the earlier of: (i) The date the plan terminates or (ii)
the time the plan becomes insolvent; (3) benefits that are not vested
because you have not worked long enough; (4) benefits for which you have
not met all of the requirements at the time the plan becomes insolvent;
and (5) non-pension benefits, such as health insurance, life insurance,
certain death benefits, vacation pay, and severance pay.
For more information about the PBGC and the benefits it guarantees,
ask your plan administrator or contact the PBGC's Technical Assistance
Division, 1200 K Street, N.W., Suite 930, Washington, D.C. 20005-4026 or
call 202-326-4000 (not a toll-free number). TTY/TDD users may call the
federal relay service toll-free at 1-800-877-8339 and ask to be
connected to 202-326-4000. Additional information about the PBGC's
pension insurance program is available through the PBGC's website on the
Internet at http://www.pbgc.gov.
(n) In the case of an employee pension benfit plan, a description
and explanation of the plan provisions for determining years of service
for eligibility to participate, vesting, and breaks in service, and
years of participation for benefit accrual. The description shall state
the service required to accrue full benefits and the manner in which
accrual of benefits is prorated for employees failing to complete full
service for a year.
(o) In the case of a group health plan, within the meaning of
section 607(1) of the Act, subject to the continuation coverage
provisions of Part 6 of Title I of ERISA, a description of the rights
and obligations of participants and beneficiaries with respect to
continuation coverage, including, among other things, information
concerning qualifying events and qualified beneficiaries, premiums,
notice and election requirements and procedures, and duration of
coverage.
(p) The sources of contributions to the plan--for example, employer,
employee organization, employees--and the method by which the amount of
contribution is calculated. Defined benefit pension plans may state
without further explanation that the contribution is actuarially
determined.
(q) The identity of any funding medium used for the accumulation of
assets through which benefits are provided. The summary plan description
shall identify any insurance company, trust fund, or any other
institution, organization, or entity which maintains a fund on behalf of
the plan or through which the plan is funded or benefits are provided.
If a health insurance issuer, within the meaning of section 733(b)(2) of
the Act, is responsible, in whole or in part, for the financing or
administration of a group health plan, the summary plan description
shall indicate the name and address of the issuer, whether and to what
extent benefits under the plan are guaranteed under a contract or policy
of insurance issued by the issuer, and the nature of any administrative
services (e.g., payment of claims) provided by the issuer.
(r) The date of the end of the year for purposes of maintaining the
plan's fiscal records;
(s) The procedures governing claims for benefits (including
procedures for obtaining preauthorizations, approvals, or utilization
review decisions in the case of group health plan services or benefits,
and procedures for filing claim forms, providing notifications of
benefit determinations, and reviewing denied claims in the case of any
plan), applicable time limits, and remedies available under the plan for
the redress of claims which are denied in whole or in part (including
procedures required under section 503 of Title I of the Act). The plan's
claims procedures may be
[[Page 398]]
furnished as a separate document that accompanies the plan's SPD,
provided that the document satisfies the style and format requirements
of 29 CFR 2520.102-2 and, provided further that the SPD contains a
statement that the plan's claims procedures are furnished automatically,
without charge, as a separate document.
(t)(1) The statement of ERISA rights described in section 104(c) of
the Act, containing the items of information applicable to the plan
included in the model statement of paragraph (t)(2) of this section.
Items which are not applicable to the plan are not required to be
included. The statement may contain explanatory and descriptive
provisions in addition to those prescribed in paragraph (t)(2) of this
section. However, the style and format of the statement shall not have
the effect of misleading, misinforming or failing toinform participants
and beneficiaries of a plan. All such information shall be written in a
manner calculated to be understood by the average plan participant,
taking into account factors such as the level of comprehension and
education of typical participants in the plan and the complexity of the
items required under this subparagraph to be included in the statement.
Inaccurate, incomprehensible or misleading explanatory material will
fail to meet the requirements of this section. The statement of ERISA
rights (the model statement or a statement prepared by the plan), must
appear as one consolidated statement. If a plan finds it desirable to
make additional mention of certain rights elsewhere in the summary plan
description, it may do so. The summary plan description may state that
the statement of ERISA rights is required by Federal law and regulation.
(2) A summary plan description will be deemed to comply with the
requirements of paragraph (t)(1) of this section if it includes the
following statement; items of information which are not applicable to a
particular plan should be deleted:
As a participant in (name of plan) you are entitled to certain
rights and protections under the Employee Retirement Income Security Act
of 1974 (ERISA). ERISA provides that all plan participants shall be
entitled to:
Receive Information About Your Plan and Benefits
Examine, without charge, at the plan administrator's office and at
other specified locations, such as worksites and union halls, all
documents governing the plan, including insurance contracts and
collective bargaining agreements, and a copy of the latest annual report
(Form 5500 Series) filed by the plan with the U.S. Department of Labor
and available at the Public Disclosure Room of the Pension and Welfare
Benefit Administration.
Obtain, upon written request to the plan administrator, copies of
documents governing the operation of the plan, including insurance
contracts and collective bargaining agreements, and copies of the latest
annual report (Form 5500 Series) and updated summary plan description.
The administrator may make a reasonable charge for the copies.
Receive a summary of the plan's annual financial report. The plan
administrator is required by law to furnish each participant with a copy
of this summary annual report.
Obtain a statement telling you whether you have a right to receive a
pension at normal retirement age (age * * *) and if so, what your
benefits would be at normal retirement age if you stop working under the
plan now. If you do not have a right to a pension, the statement will
tell you how many more years you have to work to get a right to a
pension. This statement must be requested in writing and is not required
to be given more than once every twelve (12) months. The plan must
provide the statement free of charge.
Continue Group Health Plan Coverage
Continue health care coverage for yourself, spouse or dependents if
there is a loss of coverage under the plan as a result of a qualifying
event. You or your dependents may have to pay for such coverage. Review
this summary plan description and the documents governing the plan on
the rules governing your COBRA continuation coverage rights.
Reduction or elimination of exclusionary periods of coverage for
preexisting conditions under your group health plan, if you have
creditable coverage from another plan. You should be provided a
certificate of creditable coverage, free of charge, from your group
health plan or health insurance issuer when you lose coverage under the
plan, when you become entitled to elect COBRA continuation coverage,
when your COBRA continuation coverage ceases, if you request it before
losing coverage, or if you request it up to 24 months after losing
coverage. Without evidence of creditable coverage, you may be subject to
a preexisting condition exclusion
[[Page 399]]
for 12 months (18 months for late enrollees) after your enrollment date
in your coverage.
Prudent Actions by Plan Fiduciaries
In addition to creating rights for plan participants ERISA imposes
duties upon the people who are responsible for the operation of the
employee benefit plan. The people who operate your plan, called
``fiduciaries'' of the plan, have a duty to do so prudently and in the
interest of you and other plan participants and beneficiaries. No one,
including your employer, your union, or any other person, may fire you
or otherwise discriminate against you in any way to prevent you from
obtaining a (pension, welfare) benefit or exercising your rights under
ERISA.
Enforce Your Rights
If your claim for a (pension, welfare) benefit is denied or ignored,
in whole or in part, you have a right to know why this was done, to
obtain copies of documents relating to the decision without charge, and
to appeal any denial, all within certain time schedules.
Under ERISA, there are steps you can take to enforce the above
rights. For instance, if you request a copy of plan documents or the
latest annual report from the plan and do not receive them within 30
days, you may file suit in a Federal court. In such a case, the court
may require the plan administrator to provide the materials and pay you
up to $110 a day until you receive the materials, unless the materials
were not sent because of reasons beyond the control of the
administrator. If you have a claim for benefits which is denied or
ignored, in whole or in part, you may file suit in a state or Federal
court. In addition, if you disagree with the plan's decision or lack
thereof concerning the qualified status of a domestic relations order or
a medical child support order, you may file suit in Federal court. If it
should happen that plan fiduciaries misuse the plan's money, or if you
are discriminated against for asserting your rights, you may seek
assistance from the U.S. Department of Labor, or you may file suit in a
Federal court. The court will decide who should pay court costs and
legal fees. If you are successful the court may order the person you
have sued to pay these costs and fees. If you lose, the court may order
you to pay these costs and fees, for example, if it finds your claim is
frivolous.
Assistance with Your Questions
If you have any questions about your plan, you should contact the
plan administrator. If you have any questions about this statement or
about your rights under ERISA, or if you need assistance in obtaining
documents from the plan administrator, you should contact the nearest
office of the Employee Benefits Security Administration, U.S. Department
of Labor, listed in your telephone directory or the Division of
Technical Assistance and Inquiries, Employee Benefits Security
Administration, U.S. Department of Labor, 200 Constitution Avenue N.W.,
Washington, D.C. 20210. You may also obtain certain publications about
your rights and responsibilities under ERISA by calling the publications
hotline of the Employee Benefits Security Administration.
(u)(1) For a group health plan, as defined in section 733(a)(1) of
the Act, that provides maternity or newborn infant coverage, a statement
describing any requirements under federal or state law applicable to the
plan, and any health insurance coverage offered under the plan, relating
to hospital length of stay in connection with childbirth for the mother
or newborn child. If federal law applies in some areas in which the plan
operates and state law applies in other areas, the statement should
describe the different areas and the federal or state law requirements
applicable in each.
(2) In the case of a group health plan subject to section 711 of the
Act, the summary plan description will be deemed to have complied with
paragraph (u)(1) of this section relating to the required description of
federal law requirements if it includes the following statement in the
summary plan description:
Group health plans and health insurance issuers generally may not,
under Federal law, restrict benefits for any hospital length of stay in
connection with childbirth for the mother or newborn child to less than
48 hours following a vaginal delivery, or less than 96 hours following a
cesarean section. However, Federal law generally does not prohibit the
mother's or newborn's attending provider, after consulting with the
mother, from discharging the mother or her newborn earlier than 48 hours
(or 96 hours as applicable). In any case, plans and issuers may not,
under Federal law, require that a provider obtain authorization from the
plan or the insurance issuer for prescribing a length of stay not in
excess of 48 hours (or 96 hours).
(Approved by the Office of Management and Budget under control number
1210-0039)
[42 FR 37180, July 19, 1977, as amended at 62 FR 16984, Apr. 8, 1997; 62
FR 31695, June 10, 1997; 62 FR 36205, July 7, 1997; 63 FR 48375, Sept.
9, 1998; 65 FR 70241, Nov. 21, 2000; 66 FR 34994, July 2, 2001; 66 FR
36368, July 11, 2001] 
