The Affordable Care Act (ACA) requires much more from plans and plan sponsors. Do you recognize which plans are ERISA plans and who is responsible for what? Review this to find out more.

1. PART 1 of 3
WHO DOES WHAT ON YOUR ERISA PLAN?
WHO DOES WHAT ON YOUR ERISA PLAN?
The Affordable Care Act is requiring so much more from plans and plan sponsors. Do you
recognize which of your plans are ERISA plans and who is responsible for what? Now is the time.
~ Employers who sponsor group health plans (GHPs) should be familiar with ERISA ~
Many employers
either do not
understand what
defines an ERISA GHP
Audits and
lawsuits
abound
with ERISA.
or what the
requirements are.
The PLAN SPONSOR is
generally the employer for
single employer plans.
When you attend a
sports event, the
program usually
identifies the players and
their position. Knowing
the major players in
ERISA is similarly
important in maintaining
a compliant plan:
The plan sponsor’s job is to
create, amend, maintain and
terminate the plan.
PLAN ADMINISTRATORS are generally
the plan sponsor, unless otherwise defined
in plan documents. Among other things,
this role carries out plan functions
and is ultimately liable for overall
compliance including Form 5500s, claims
administration and notices.
The plan must designate a named
fiduciary that handles claims and
appeals and performs other functions
that require a high degree of trust
or discretion. Other individuals who
perform specified tasks could also
become plan fiduciaries.
Insurers, HMOs and TPAs are not
directly responsible for the ERISA
compliance for the employer’s plan, but
provide administrative services
related to plan compliance.
Participants
and
beneficiaries
are those that benefit
from the ERISA plan.
Participants must meet
the plan’s eligibility
requirements and
typically are current
employees, retirees
and COBRA qualified
beneficiaries.
Beneficiaries are
typically spouses and
dependents who enjoy
plan benefits due to
the relationship with
participants.
If an ERISA plan chooses
to hold their general
assets in a trust, then
the plan documents
must designate a
trustee.
copyright 2013