Do I Need to Read the Plan Document or the Summary Plan Description? What is the Difference?

Do I Need to Read the Plan Document or the Summary Plan Description? What is the Difference?

When you receive coverage through a long-term disability benefits plan governed by ERISA, the plan administrator is required to provide you with a copy of the summary plan description (SPD) free of charge. This is an important document that tells you what benefits the plan provides and how the plan works. Among other things, the SPD should provide you with a description of plan benefits, with specific information about:

·         When you can begin to participate in the plan

·         How benefits are calculated

·         When and how benefits are paid

·         How to file a claim for benefits

·         Your rights under ERISA

Additionally, if the plan changes, then the plan administrator must give you and all beneficiaries of the plan a revised SPD or a summary of material modifications. Both the SPD and any revisions or modifications must be written in a manner that is designed to be easily understood by the average plan participant.

On the other hand, the plan document is a written instrument that governs all ERISA plans. It is a far more comprehensive document that outlines the rights of plan participants and beneficiaries, the benefits available, eligibility criteria, how benefits are funded, how the plan can be amended, and procedures for allocation of plan responsibilities.

Although plan administrators are not required to automatically provide plan participants with the plan document, unlike the SPD, they are required to furnish it to participants upon request within 30 days. Failure to provide the plan document can result in daily penalties. In some situations, an ERISA-governed benefits plan will have a combined SPD and plan document. If a plan chooses to exercise this option, it must comply with both the rules for SPDs, as well as those for plan documents.

ERISA plan documents and even the summary plan description can be difficult to comprehend and even misleading at times. At Bonnici Law Group, we offer you client-centered representation at all stages of the long-term disability benefit claims process. When you need the kind of help that only an experienced long-term disability benefits attorney can offer you, contact Bonnici Law Group at 619-259-5199 or help@bonnicilawgroup.com.

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