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ERISA

Seminar Summary

The seminar began with an overview of the purpose of ERISA, requirements and the elements of an ERISA plan. We delved into administration (including disclosure requirements, compliance regulations and standard of conduct), and offered advice for successfully navigating the increased scrutiny of ERISA guidelines.

Presenter

Nimesh R. Patel, JD, Unum Insurance Company

Top Takeaways

  1. What constitutes an ERISA plan

    There are five elements to an ERISA program:
    1. Plan / fund or program
    2. Established or maintained
    3. By an employer, employee organization or both
    4. Exist for the purpose of providing welfare or retirement benefits
    5. to participants and beneficiaries.

  2. Employer responsibilities

    ERISA requires the disclosure of certain information about the welfare benefit plan:
    • Plan documents
    • Summary Plan Description (SPD)
    • Summary of Material Modification (SMM)
    • Summary Annual Report (SAR).

    All of these documents must be furnished in a way that is “reasonably calculated to ensure actual receipt by all participants covered under the plan.”

    Approved methods include US Mail, special insert in company publication and in–hand delivery. SPDs and SMMs can be delivered electronically.
  3. Reporting requirements

    • Form 5500
    • Schedule A
    • Schedule C

  4. Employers who qualify for ERISA

    The ERISA law stipulates that plans covering at least one person are subject to the ERISA regulations. Additionally, form 5500 is only required for health and welfare plans with at least 100 subscribers.
  5. Participant and claimant rights

    Disclosure and Reporting (SPD, SMM, SAR), Benefit Determinations (Timing, Notice, Appeals). An ERISA welfare benefit claim is a request for benefits, by a claimant, in accordance with the plans reasonable procedure.

    There are four basic steps to the ERISA Claims procedure:
    1. Submission
    2. Determination
    3. Appeal
    4. Review

Presentation and Seminar Materials

The presentation materials shared in this seminar can be downloaded from TriSure Online. Contact Darlene Pease at 919-469-2473 if you've forgotten your login information or to register for an account.