Virtually every health plan sponsored by a private employer must provide a Summary Plan Description (SPD) to plan participants. Often, the employer relies on an insurer or a consultant to prepare the SPD, but if there are problems with the SPD the employer will generally be responsible for dealing with them. There are many requirements for SPDs and there are many other provisions that should be included, although not required. The language and format of an SPD are also important, as the SPD must be written in a manner calculated to be understood by the average plan participant. Some SPD provisions can be stated simply and clearly but others may be lengthy and detailed and making them all understandable can be a challenge. Countless lawsuits have been brought by plan participants claiming that the plan’s SPD was unclear, failed to include relevant information, misstated plan provisions, or was not properly distributed. An SPD that is easy-to-read, well-organized, well-indexed, and accurate can be the difference between winning or losing a lawsuit.
Please join Christine Williams, founder of Health Plan Plain Talk, as she reviews the requirements for a compliant SPD, points out common mistakes, and provides tips to improve your SPD.
WHAT YOU’LL LEARN
Just a sampling of what this webinar will cover:
- The basic requirements for an SPD
- SPD provisions that are not required but are useful
- Whether an employer-sponsored health plan must have a plan document in addition to an SPD
- Who is responsible for the SPD
- For an insured plan, why the benefits booklet or evidence of coverage from the insurer is not enough and what needs to be added
- Determining appropriate language for the average plan participant
- Suggestions for dealing with the SPD provisions that are hardest to simplify
- The importance of accuracy and consistency
- The value of an index
- Delivery of the SPD to plan participants
- AND MUCH MORE!
YOUR CONFERENCE LEADER
Your conference leader for “Summary Plan Descriptions for Employer-Sponsored Health Plans: Requirements, Common Pitfalls, and Simple Fixes” is Christine Williams. Ms. Williams has worked in the employee benefits field since 1987, both in private practice and as in-house counsel to a Fortune 100 company, and recently founded HealthPlanPlainTalk.com, an online resource for benefit plan sponsors and employee benefit professionals. She has extensive experience with all types of health and welfare plans, and was the editor and a contributing author of HIPAA Portability, Privacy, & Security, published by the Employee Benefits Institute of America (EBIA), a division of Thomson Reuters, and is now a contributor to that publication. She was a contributing author of Health Care Reform for Employers and Advisors, also published by EBIA. She has provided advice on HIPAA, health care reform, and benefit plan compliance to a wide range of health plans, employers that sponsor health plans, and business associates, and she regularly teaches seminars for employee benefit professionals. Before moving into employee benefits, Ms. Williams was a trial attorney at the U.S. Department of Justice and an assistant professor at the University of Maryland School of Law. She earned her J.D. degree from the University of Kentucky College of Law.