Updated ERISA Wrap Documents

Effective April 1, 2018, a new rule from the US Department of Labor (DOL) requires ERISA-covered employee benefit plans to re-issue plan documentation (ERISA Wrap documents) to all participants. While the rule is in effect, you have 210 days to comply with this new ruling.

As the employer, you need to complete the following steps:

1. Sign the updated Wrap Plan Document and retain for records
2. Distribute the updated Wrap Summary Plan Document (SPD) and have your employees sign the acknowledgement form
3. Retain the signed Employee Acknowledgment of Receipt of SPD document to prove SPDs have been received
4. All other documents are for your records (including any Premium Conversion Plan documents, if applicable, and Guidelines of Distribution)

The most notable changes to claim processing requirements, include:

• Improvement to Basic Disclosure Requirements. Benefit denial notices must include a more complete discussion of why the plan denied a claim and the standards used in making the decision. For example, in relevant cases, the notice must explain why the Plan Administrator disagrees with the opinions of the participant’s or beneficiary’s health care professionals, vocational experts, or the Social Security Administration’s determination of disability.
• Right to Internal Protocols. Benefit denial notices must include the internal rules, guidelines, protocols, standards, or other similar criteria of the plan that were used in denying a claim, or a statement that none were used.
• Access to Claims File. The Plan Administrator must inform participants, in benefit denial notices (rather than simply in notices denying benefits on appeal), that they are entitled to access, upon request and free of charge, all documents relevant to an adverse claim determination.
• Avoiding Conflicts of Interest. Plans must ensure that disability benefit claims and appeals are adjudicated in a manner designed to ensure the independence and impartiality of the persons involved in making the decision.

**This notice was sent to us from one of our ERISA Wrap Document providers, BASE. Please contact us if you have any questions.