Title: ERISA Compliance for Employer Health Plans Source: https://ethosbenefits.com/services/erisa-compliance Publisher: Ethos Benefits Summary: Ethos Benefits keeps your health and welfare plans ERISA compliant: plan documents, SPDs, required disclosures, Form 5500, bonding and provider disclosures. 1. [Home](https://ethosbenefits.com/) 2. [Services](https://ethosbenefits.com/services) 3. ERISA compliance. # ERISA compliance. Documents, disclosures and filings. If your company sponsors a health or welfare plan, ERISA requires a written plan, specific disclosures to employees, annual reporting and fiduciary conduct. Ethos Benefits reviews and maintains your plan documents, tracks every required disclosure and filing, collects service provider compensation disclosures, and gives you access to ERISA attorneys. [Request a Strategic Analysis](https://ethosbenefits.com/strategic-analysis) ## What you get. Many health plans run on carrier certificates that were never pulled into an ERISA plan document. The gaps usually surface during an audit, a claim dispute or a lawsuit. 1. **Plan and wrap documents** A written plan document, and a wrap document where needed, so every benefit sits under one ERISA plan. 2. **Summary Plan Description** An SPD that matches how the plan actually runs, distributed on time and updated when it should be. 3. **Summaries of Material Modifications** Changes to the plan disclosed to participants within the required window. 4. **Form 5500 and Summary Annual Report** The annual filing prepared or supported, and the SAR distributed to participants. 5. **408(b)(2) disclosures** Compensation disclosures collected from every covered service provider and reviewed every year. 6. **ERISA attorney access** Plan interpretation questions answered by ERISA counsel, with the guidance kept in your record. ## What ERISA _requires._ | Item | What it is | When | | --- | --- | --- | | **Plan document** | The written terms of the plan | In place at all times | | **Summary Plan Description** | The plan explained in plain language | Within 90 days of becoming a participant; restated every five years if amended, every ten if not | | **Summary of Material Modifications** | Notice of a change to the plan | Within 210 days after the end of the plan year of the change; within 60 days for a material reduction in group health benefits | | **Form 5500** | The plan’s annual report | The last day of the seventh month after the plan year ends, with an extension available | | **Summary Annual Report** | A summary of the Form 5500 | Nine months after the plan year ends, or two months after an extended 5500 deadline | | **Claims procedures** | How claims and appeals are decided | Described in the SPD and followed every time | ## Conduct, _not just paperwork._ ERISA also governs how the plan is run: loyalty, prudence and following the plan documents. Documents without a process leave your committee exposed. [Read what a fiduciary owes the plan](https://ethosbenefits.com/fiduciary), and how [fiduciary governance](https://ethosbenefits.com/services/fiduciary-governance) keeps the record. ## An audit _at the start._ When Ethos begins with a plan, every document, notice and filing is reviewed. The gaps are listed, prioritized and fixed, and the result becomes the baseline for your compliance calendar. ## Part of your Fiduciary Framework™. Every Ethos service reports to your benefits committee. The work is reviewed at your quarterly committee meeting, each decision is recorded with the reasoning behind it, and the record lives in your Ethos Fiduciary OS. That is what lets your committee show the plan was run prudently. [See the Fiduciary Framework™](https://ethosbenefits.com/fiduciary-framework) · [How fiduciary governance works](https://ethosbenefits.com/services/fiduciary-governance) ## Related reading. - [**ERISA vs. non-ERISA** Benefits 101: How ERISA and non-ERISA health and welfare plans differ: which plans are exempt, and how reporting, fiduciary duties, claims rules and legal remedies compare.](https://ethosbenefits.com/benefits-101/erisa-vs-non-erisa) - [**Who is subject to ERISA?** Benefits 101: Private employers' health plans fall under ERISA. See which plans are exempt, including government, church and some voluntary plans, and what the rest must do.](https://ethosbenefits.com/benefits-101/who-is-subject-to-erisa) - [**ERISA wrap documents** Benefits 101: What an ERISA wrap document is, what it must include, how it differs from an SPD, the disclosure deadlines, and the 2026 penalties for missing them.](https://ethosbenefits.com/benefits-101/erisa-wrap-document) - [**The summary plan description** Benefits 101: What a summary plan description is, what ERISA requires it to include, when it must be delivered, and how it differs from the plan document and the SBC.](https://ethosbenefits.com/benefits-101/summary-plan-description) [Browse everything in Learn](https://ethosbenefits.com/learn) ## Sources 1. [Reporting and Disclosure Guide for Employee Benefit Plans](https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/reporting-and-disclosure-guide-for-employee-benefit-plans), U.S. Department of Labor, Employee Benefits Security Administration 2. [Understanding Your Fiduciary Responsibilities Under a Group Health Plan](https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/understanding-your-fiduciary-responsibilities-under-a-group-health-plan), U.S. Department of Labor, Employee Benefits Security Administration ## Questions employers ask about this. Does every ERISA plan need an SPD? Yes. Every ERISA-covered plan must provide a Summary Plan Description to participants, regardless of size or whether it is insured or self-funded. What is a wrap document? A wrap document is a plan document that brings insurance certificates and other benefit documents under one ERISA plan and adds the provisions ERISA requires that carrier documents leave out. Who files the Form 5500? The plan administrator, which is usually the employer. Plans with 100 or more participants generally must file, and so do self-funded plans that hold assets in a trust. When does an SPD have to be updated? A restated SPD is generally due every five years if the plan has been amended, and every ten years if it has not, with SMMs in between. ## Keep reading Related to this page. - [**Compliance** Ethos Benefits keeps your health and welfare plans compliant with ERISA, the ACA, COBRA, HIPAA, mental health parity and the CAA, with every item proven. _Read more_](https://ethosbenefits.com/services/compliance) - [**Fiduciary governance** Ethos Benefits sets up and runs your health plan benefits committee, with a charter, quarterly meetings, minutes and a record of every decision and why. _Read more_](https://ethosbenefits.com/services/fiduciary-governance) - [**ACA compliance and reporting** Ethos Benefits keeps your company ACA compliant: employer mandate, affordability, SBCs and PCORI fees, plus Forms 1094-C and 1095-C as an added service. _Read more_](https://ethosbenefits.com/services/aca-compliance) - [**Nondiscrimination testing** Ethos Benefits runs Section 125, dependent care and Section 105(h) nondiscrimination testing so your plans keep their tax advantages for every employee. _Read more_](https://ethosbenefits.com/services/nondiscrimination-testing) - [**Mental health parity** Ethos Benefits coordinates your plan’s NQTL comparative analysis under the Mental Health Parity and Addiction Equity Act and keeps it current. _Read more_](https://ethosbenefits.com/services/mental-health-parity) ## See what your plan is really costing you. A Strategic Analysis starts with your plan documents and your broker agreement, then shows you what your plan costs, where the risk sits, and what a committee would decide with the full picture. [Request a Strategic Analysis](https://ethosbenefits.com/strategic-analysis) [Call (407) 803-4710](tel:+14078034710)