How to Furnish an ERISA Summary Plan

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healthcare-lien-resolutionQuestion: Must a participant/beneficiary sign something showing receipt of the summary plan description? Who has the burden of proving that the beneficiary received the SPD?

 

 

Answer: ERISA does not require that a participant/beneficiary sign anything upon receipt of the Summary Plan Description. Under ERISA, 29 USC § 1024(b)(1), the administrator must furnish the beneficiary with a copy of the SPD. However ERISA does not provide standards to judge whether or not this duty of disclosure has been met.

The burden of proving receipt will generally fall upon the administrator. However the burden is very light and in most cases liability will not be imposed unless a request was made by the beneficiary. More importantly, to receive damages the beneficiary must show substantive harm or prejudice (§ 1104).

Case law regarding basic furnishment of the SPD is very sparse. However if the case involves a beneficiary's request for documentation and subsequent denial, the burden upon the administrator becomes much heavier. However even in these situations, the failure to provide does not change the language or terms of the policy.

I hope this information helps.


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