Health Plans & Benefits
- Child Care Assistance
- Compliance Assistance
- Consumer Information on Health Plans
- Continuation of Health Coverage (COBRA)
- Employee Retirement Income Security Act (ERISA)
- Fiduciary Responsibilities
- Health Benefits Education
- Mental Health Benefits
- Newborns' & Mothers' Protections (Newborns' Act)
- Participant Rights
- Plan Information
- Portability of Health Coverage (HIPAA)
- Womens' Health & Cancer Rights Protections
The Employee Retirement Income Security Act (ERISA) requires plan administrators the people who run plans to give plan participants in writing the most important facts they need to know about their retirement and health benefit plans including plan rules, financial information, and documents on the operation and management of the plan. Some of these facts must be provided to participants regularly and automatically by the plan administrator. Others are available upon request, free-of-charge or for copying fees. The request should be made in writing.
One of the most important documents participants are entitled to receive automatically when becoming a participant of an ERISA-covered retirement or health benefit plan or a beneficiary receiving benefits under such a plan, is a summary of the plan, called the summary plan description or SPD. The plan administrator is legally obligated to provide to participants, free of charge, the SPD. The summary plan description is an important document that tells participants what the plan provides and how it operates. It provides information on when an employee can begin to participate in the plan, how service and benefits are calculated, when benefits becomes vested, when and in what form benefits are paid, and how to file a claim for benefits. If a plan is changed, participants must be informed, either through a revised summary plan description, or in a separate document, called a summary of material modifications, which also must be given to participants free of charge.
In addition to the summary plan description, the plan administrator must automatically give participants each year a copy of the plan's summary annual report. This is a summary of the annual financial report that most plans must file with the Department of Labor. These reports are filed on government forms called the Form 5500. The summary annual report is available at no cost. To learn more about the plan assets, participants may ask the plan administrator for a copy of the annual report in its entirety.
If participants are unable to get the summary plan description, the summary annual report or the annual report from the plan administrator, they may be able to obtain a copy by writing to the U.S. Department of Labor, EBSA, Public Disclosure Room, Room N-1513, 200 Constitution Avenue, N.W., Washington, D.C. 20210, for a nominal copying charge. Participants should provide their name, address and phone number to enable EBSA to contact them to follow up on the request.
Provides information to assist employers and employee benefit plan practitioners in understanding and complying with the requirements of ERISA as it applies to the administration of employee pension and welfare benefit plans.
Consumer Information on
Provides fact sheets, booklets, and other health plan information from the Department's Employee Benefits Security Administration (EBSA).
EFAST ERISA Filing
The EFAST system streamlines filing and processing of the annual return/report forms through the use of computer scannable forms and electronic filing technologies. This Web site provides assistance on using the EFAST system.
Questions & Answers:
EFAST ERISA Filing Acceptance System
Provides answers to commonly asked questions about the EFAST system.
An Employee's Guide to Health Benefits Under
COBRA gives workers and their family members who lose their health benefits in certain circumstances the right to choose to continue group health benefits provided by their health plan. This publication provides a detailed overview of the law.
How to File a
Claim for Your Health and Disability Benefits
Provides advice to participants about how to file a claim for benefits and what to do if the claim is denied.
Obtain Employee Benefit Plan Documents from the Department of
Describes the documents and materials available through the EBSA public disclosure room and how you can obtain the documents from them.
Pension & Health Care Coverage...Questions & Answers for Dislocated
Provides answers to commonly asked questions by dislocated workers about their pension and health benefits.
Question & Answer
Guide: Filing the Form M-1
Provides questions and answers about Form M-1 Annual Report for Multiple Employer Welfare Arrangements (MEWAs) and Certain Entities Claiming Exception (ECEs).
Your Health Plan and HIPAA ... Making the Law Work for You
Provides information about major provisions of the Health Insurance Portability and Accountability Act, the Newborns' and Mothers' Health Protection Act, the Mental Health Parity Act, and the Women's Health and Cancer Rights Act.
Top 10 Ways to
Make Your Health Benefits Work for You (Español)
Provides ten tips to help make your health benefits work better for you.
Women's Health &
Cancer Rights Act (WHCRA)
The WHCRA contains protections for patients who elect breast reconstruction in connection with a mastectomy. This fact sheet provides a brief overview of the law.
Bankruptcy: How Will it Affect Your Employee Benefits?
Provides information about bankruptcys effect on pension plans and group health plans.
Frequently Asked Questions for
Plan Sponsors Related to Filing Relief
The Employee Benefits Security Administration, the Internal Revenue Service, and the Pension Benefit Guaranty Corporation have extended the deadline for filing the Form 5500s and Form 5500-EZs as a result of the events of September 11, 2001. These questions and answers provide general information about the filing relief.