Not legal advice. Educational guide to general U.S. employment law. Rules vary by state — consult an employment attorney for specific cases.
01
The per-participant documents
Summary Plan DescriptionERISA's foundational disclosure: what the plan covers, who's eligible, how claims work — in language an average participant understands. Due within 90 days of a participant joining; restated every 5 years if amended, 10 if not. A missing SPD also means your claims procedures and limitation periods may not bind.
Summary of Benefits and CoverageThe ACA's standardized comparison card — at initial enrollment, annual renewal, and within 7 days on request. Insurers draft it; you owe the distribution, on penalty per failure.
Summary of Material ModificationsPlan changes: within 210 days after the plan year — but 60 days for material reductions in health coverage. The mid-year benefits cut has a notice deadline most employers miss.
02
The annual calendar
Before October 15Medicare Part D creditable-coverage notice to Medicare-eligible participants — timed to the Part D enrollment window; the CMS online disclosure follows within 60 days of the plan year.
Open enrollmentSBCs for each option; CHIP premium-assistance notice (the DOL model updates twice a year); WHCRA mastectomy-rights notice; grandfathered-status notice where applicable; wellness and HIPAA notices as your plan design requires.
July 31 (calendar-year plans)Form 5500 for plans with 100+ participants — the filing whose absence is visible to the DOL by definition. PCORI fees for self-insured plans, same date, via Form 720.
03
Event-triggered notices
At hire: the marketplace coverage notice to every employee within 14 days — eligible for your plan or not — plus the CHIP notice and any wellness disclosures with the new-hire packet. At separation or hours reduction: the COBRA election machinery, plus a certificate of the coverage end-date for the employee's marketplace special-enrollment window — sequenced in the exit-benefits guide. On FMLA leave: maintenance-of-coverage terms. On a HIPAA special-enrollment event (birth, marriage, loss of other coverage): the 30-day enrollment right your plan documents promise. Each notice is small; the pattern — event fires, notice follows — is what needs to be built once.
04
Delivery rules and automation
Delivery is its own compliance layer: DOL electronic-delivery rules cover employees whose duties include computer access (email works, with the right-to-paper statement); everyone else needs consent or mail. Intranet posting alone delivers nothing. The sustainable design treats notices as data, not memory: an annual compliance calendar owned by one named role, notice templates versioned with the plan year, delivery logged per employee per notice — because in an audit or a lawsuit, proof of delivery is the difference between a checklist and a defense. Most carriers and PEOs generate the documents; what they don't do is prove your people received them. That part stays yours.
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Frequently asked questions
What's the difference between an SPD and an SBC?The SPD is ERISA's full plain-language description of the plan — eligibility, benefits, claims procedures — due within 90 days of joining. The SBC is the ACA's standardized 4-page comparison document, due at enrollment and renewal, with a $1,000-plus per-failure penalty. The insurer typically drafts the SBC; the employer must actually distribute it.
Do small employers owe these notices too?Most of them, yes. ERISA notices (SPD) apply to plans of any size; the CHIP, Part D and marketplace notices don't carry small-employer exemptions. The main size-based relief: plans under 100 participants generally skip the Form 5500, and under-20 groups escape federal COBRA (but usually not state continuation).
What is the Medicare Part D creditable coverage notice?An annual letter, due before October 15, telling Medicare-eligible participants whether the plan's drug coverage is 'creditable' (at least as good as Part D). Miss it and employees who delay Part D enrollment face lifetime premium penalties — which they will attribute, correctly, to your missing letter. A parallel disclosure files with CMS.
Can we deliver everything electronically?Under DOL rules, email delivery works for employees with work-related computer access as part of their duties; others need affirmative consent or paper. Posting on an intranet alone doesn't satisfy delivery — the notice has to be sent, with the disclosure-rights statement attached.
