Summary Plan Descriptions (SPDs)

A plan administrator is the person or company your employer selects to manage its benefits plan(s). The administrator works with the plan provider to ensure that the plan meets government regulations. In many cases, companies administer their own plans and the responsibility falls to an individual or group of individuals working for the company who take on the tasks of plan selection and administrative decision-making. 

Please note that Zenefits is not your plan administrator.

The deductible limit is the maximum amount in a given year that a plan participant may have to pay in deductibles before the plan coverage is required to satisfy the full amount of claims.

• A calendar year deductible, which is what most health plans operate on, begins on January 1st and ends on December 31st. Calendar-year deductibles reset every January 1st. 
  
• A plan year deductible resets on the renewal date of your company's plan. For example, if your health plan renews on May 1st, then your deductible would run from May 1st to April 30th of the following year, and reset on May 1st. 
  

Your carrier may specify this in your contract - try searching for annual deductible, deductible, or calendar year. If you are having trouble locating this information, please contact your Benefit Advisor, Account Manager, or carrier. 

If you have more than one renewal date, please pick the earliest of dates. For example, if you have a calendar year deductible, and a plan year deductible of June 1st, select the calendar year (January 1). 

ERISA legally obligates the plan administrators to provide important facts regarding their retirement and health benefit plans. All participants are entitled to automatically receive an SPD, free of charge.

If a plan is changed, participants must be informed either through a revised summary plan description or in a separate document. This is called a summary of material modifications, which must also be given to participants free of charge.

The SPD tells participants:

• What the plan provides and how it operates
  
• 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

For more information please visit the Department of Labor's page on this topic. 

No, it is not required for you to reprocess them. However, you may wish to complete the flow in order to store a digital copy in your documents section.

If you choose to distribute SPD's  through Zenefits, you will be prompt to download or distribute your completed SPD once the flow is finished. An email won't be sent to employees, however, they will see a pending item in the notifications center (displayed as red dot on the bell on the top-right corner of their dashboard) stating that their SPD is available in the Documents section of their account.

Most error messages come from the file name being too long, or the file being password protected. We have included some troubleshooting tips below.

Use Chrome to open the  PDF file, then right click on file content, choose Print, then save as PDF. The new file should work with no error message. 

If you continue to receive an error message, please reach out to our support team through our Contact Us page for further assistance.

If on the first day of the group's ERISA plan year (renewal), the company had 100 or more participants enrolled in coverage, then they will need to file a Form 5500 for their Health and Welfare Benefit plan. A group health plan with fewer than 100 employees that is either fully-insured or self-funded (or a combination of both) is generally not required to file Form 5500.

Zenefits does not file the plan with the Department of Labor, however, this can be done online.

For more information regarding filing the ERISA Form 5500, please see this Help Center article or visit this Department of Labor page.

1. Company administrators will receive an inbox task to complete their Summary Plan Description, or SPD, about 45 days after their renewal.

• Alternatively, admins can access the SPD by clicking into the Benefits Adminstration card, clicking the Company tab, and selecting the Summary Plan Description option from the menu bar

2. Clicking Get Started will take you into the overview of the SPD process.

3. Clicking Generate an SPD will take you to the first part of the SPD creation process. All you need to do on this page is confirm that all of the information is correct. Please also note that the contact information for your insurance carriers is provided as you may need this later on.

4. Clicking Confirm will take you to the next step, where you will need to enter some information about the plans offered by your company. 

• You will be asked to determine if you have filed a plan name with the Department of Labor. If Yes is selected, you will then be prompted for more information about this filing. Hovering over this question will bring up more information about how you can determine if you filed a plan name on the right side of the screen. Please see this Department of Labor page on Plan Information for details.
  
• If your plans run on a calendar year (renewal date is 1/1), that would be considered Calendar Year. If your plans do not run on a calendar year (renewal date is anything other than 1/1), that is considered Plan Year. If your plans have different renewal dates, you can follow the renewal date that is earliest in the year (for example, if your medical renews 3/1 and your dental renews 9/1, use 3/1 as the beginning of your plan year)
• Select whether or not your company offers an FSA or HSA
• Fill out the plan administrator information. Zenefits is not your plan administrator. This should be the person at your company who is responsible for making benefits decisions, typically the HR contact.
• The Agent for Service of Legal Process will be the person or company designated to accept service of process on behalf of the company. This is often the CEO or other high ranking executive. Zenefits is not your Agent for Service of Legal Process.

5. On this step, you'll see a draft of the first part of the SPD. Confirm that what you see is correct and click Next.

• If you realize you have missed information, or need to edit, there is the option to go Back.

6. The final step of the SPD process is to upload policy booklets from your insurance carriers. You will use the blue Upload link to add the booklets to your SPD.

• Insurance carriers should proactively be providing these documents to administrators after renewal. If you haven't received your booklets, then please use the contact information to contact them and request these.
  
• Sometimes insurance carriers can refer to these policy booklets as Certificates of Coverage, Evidence of Coverage, or Benefits Booklets/Handbooks.
• Please use some of the other Help Center pages (linked to the right side of the page) to help troubleshoot the policy book upload process.

7. Clicking Next will take you to a page where you can view and download the completed SPD.

• Clicking the Send to Employees button will automatically upload the SPD to their profile and notify them via inbox task. This will not send them an email!
• If you need to modify or add something in the SPD, please download so you can make these changes. You will not be able to upload this modified SPD back into the SPD section. Instead, you can use custom fields to upload to employees' profiles.