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ERISA and the Internal Revenue Code demands that several major reports or items of disclosure be prepared for each plan or funding vehicle.

  1. Annual Report
    The so-called 5500 series describes the plan’s characteristics and is provided to    both the IRS and the Department of Labor.
  2. Summary Annual Report
    This report is for plan beneficiaries and is a capsule of the Form 5500.
  3. Summary Plan Description
    This item is more commonly referred to as the plan booklet. It is prepared for the plan beneficiaries and describes in understandable language the plan benefits and operation.
  4. Tax Filings
    These are for the IRS and deal exclusively with trust filings and plans offering certain fringe benefits (premium option plan, e.g.).

Administration

There are three ways of administering the self-funded plans:


  • Third party administrator


  • Insurer administrator


  • Employer or self-administrator


The administrator’s duties are rather extensive, reflective of the truth that such self-funded plan is, in effect, a miniature insurance company:


  • Accounting (employer, plan, trust are entities which require accounting and/or auditing)


  • Actuarial (COBRA premiums, funding levels, reserves, etc.)


  • Benefit processing


  • Recordkeeping


  • Managed care-related (utilization review, arranging for benefit carve-outs, provider-assumed risks, etc.)