If you request a plan design change, you will receive new certificates, or the necessary pages to update those certificates you have distributed and those you have in supply. We will provide instructions with any new forms.
The list bill is the most commonly selected bill type. The list bill shows each employee and the amount of premium due for each applicable coverage. Any additions, terminations and changes that occur between billing periods will be reflected on your next invoice after the changes have been made; therefore, please pay premium as billed.
Link to sample of list bill
MetLink and Billing
Access MetLink to accomplish your billing needs. MetLink users can view the following:
- Current bills
- Current invoices
- Billing history
- Payment inquiries
You can also print current invoices, receive email billing notifications, and suppress paper bills. Log into MetLink and click on the Billing section.
For further help navigating through the MetLink Billing section, access the Resources tab on MetLink to view your customized user guide.
If you are currently not a MetLink user, contact your MetLife Representative or broker.
If You Have Selected The Self-Administered Billing Option
With the self-administered bill option, you are responsible for tracking and reporting additions, terminations and changes that occur between billing periods. The self-administered bill reports premium due for the total number of insured lives for each coverage. You then make the appropriate adjustments in your totals for the month and mail the revised billing statement and premium to MetLife.
Link to sample of self-administered bill
Example Of How To Calculate LTD Premium
Long Term Disability (LTD):
(Maximum Covered Monthly Payroll ÷ 100 x Rate = LTD Premium Due)
Rate per $100 of Covered Monthly Payroll
Example: Covered Monthly Payroll ($2,000) ÷ $100 x Rate (.50) = LTD Premium Due ($10)
The rates shown are for example purposes only. To protect Employee privacy, the billing statement shows benefit amount versus covered monthly payroll. Contact 1-800-ASK-4-MET (1-800-275-4638) with questions concerning your rates.
How to Read Your Billing Statement
To help you better understand MetLife's billing procedures, sample bill formats are included along with an item-by-item explanation of information it contains. Please contact Customer Service at 1-800-ASK-4-MET (1-800-275-4638) if you have questions about an item or any aspect of our billing process.
MetLife reserves the right to audit your records periodically to ensure the accuracy of premium calculations.
Please note: There is a $25.00 fee for all premium checks returned due to insufficient funds.
To terminate your policy, please follow these steps:
- Notify MetLife in writing. Notification should be sent to MetLife at least 60 days before your specified termination date. The policy will end on the later of the date stated in the notice; or the date MetLife receives the notice.
- Pay all unpaid premiums for the time your policy was in force. If MetLife receives a notice of termination request, all outstanding premiums must be paid in full before your request can be processed.
Please submit all request for termination to:
Fax 1-888-505-7446
Small Market Administration
PO Box 14593
Lexington, KY 40512-4593
Electronic Funds Transfer (EFT) provides a new payment option for list billed customers to remit premium electronically from your bank to ours, without the resources and costs associated with requesting and issuing a manual check each month.
You will continue to receive a List Billing statement. The last page will state
“Amount To Be Drafted” instead of balance due. The premium will be drafted from your authorized bank account on each bill due date.
To implement the EFT payment option, complete the Authorization for Electronic Fund Transfer Form and attach a copy of a voided business check.
Remit the EFT form and voided check to:
MetLife
Small Market
P.O. Box 14593
Lexington, KY 40512-4593
Or Fax to:
Attn: MetLife-Small Market
Subject: EFT Authorization Form
Fax: 1-888-505-7446
Eligibility requirements and effective dates may vary by group and/or type of coverage.
Actively at work requirements may vary by group and/or type of coverage. Generally, if the Employee is not actively at work on the day coverage would otherwise become effective because of layoff, leave of absence or disability, the coverage becomes effective on the date that the Employee returns to active work.
Generally, if the effective date of coverage falls on a day on which the Employee is not scheduled to work or during the Employee's vacation period or weekend, the Employee shall be considered to be actively at work, provided the Employee worked on the last scheduled work day or the day immediately preceding the vacation period.
Enrollment of New Employees for Contributory vs. Non-Contributory Coverages
Non-Contributory Coverage means the cost of the coverage is fully paid by the Employer.
- 100% of all eligible Employees must be enrolled.
- Eligible Employees cannot waive non-contributory coverage.
Contributory Coverage means the employee pays all or a portion of the cost of the coverage.
- Employees are not required to enroll for the coverage.
Enrollment of New Employees for Contributory Coverages
Once new employees have met the requirements for coverage, they have 31 days to enroll in your group plan. Employees who do not enroll within this 31-day period are considered late enrollees. Late enrollees may apply for coverage at any time, subject to certain restrictions. Please refer to the Late Enrollments section of this manual for more details. Any employee who chooses to waive coverage must complete the waiving coverage section and sign the Enrollment Form.
For all benefits, except dental, employees must complete a Statement of Health Form for coverage amounts in excess of the non-medical maximum that can be found in the Schedule of Benefits in your Certificate of Insurance
Enrollment of New Employees for Non-Contributory Coverages
Once new employees have met the requirements for coverage, they have 31 days to enroll in your group plan. All employees are to be covered on the date they are eligible. There are no late enrollments for non-contributory benefits. Enrollments processed after the billing period has ended for the eligibility date will be back-billed on the first available billing after the enrollment has been received and processed. Any employee who chooses to waive coverage must complete the waiving coverage section and sign the Enrollment Form.
The completed Enrollment Form should be sent to MetLife. Keep a copy of the Enrollment Form in your files as evidence that the new employee was given the opportunity to enroll. All requested information is necessary to promptly and accurately enroll your employees.
For all benefits, except dental, employees must complete a Statement of Health Form for coverage amounts in excess of the non-medical maximum that can be found in the Schedule of Benefits in your Certificate of Insurance.
Checking Enrollment Applications
For List Billed Cases: Incomplete or missing information on the Enrollment Form may delay coverage for your employees. Please check to see that all required forms are completed before submitting them to MetLife. Keep a copy of the Enrollment Form for your files.
For Self-Administered Cases: Please check that all required forms are completed and signed. Keep these Enrollment Forms in your files. MetLife will use the information to determine eligibility for benefits at the time of claim.
MetLink and Enrollment
On MetLink you can maintain employee and dependent eligibility.
You will have the ability to:
- Enroll new employees
- Terminate coverage
- Reinstate coverage
- Add/Change dependent status
For Group enrollment, you can view:
- Enrollment listings
- Plan structure
Log into MetLink and click on the Enrollment Services section.
For further help navigating through the MetLink Enrollment Services section, access the Resources tab on MetLink to view your customized user guide.
If you are currently not a MetLink user, contact your MetLife Representative or broker.
Domestic Partner means each of two people, one of whom is insured under the Policy, who represent themselves publicly as each other's domestic partner and have satisfied certain conditions set-forth in the Certificate of Insurance. Review your Certificate of Insurance to verify if your plan provides Domestic Partnership benefits. A Domestic Partner can become a qualified dependent for Dental, Life and AD&D if the requirements listed in the Certificate of Insurance are met.
The insured and the declared domestic partner are required to fill out the appropriate Domestic Partnership Form. Retain the form in your files.
For more specific information concerning the Domestic Partnership option, please refer to your group Certificate of Insurance.
For more information, contact Customer Service at 1-800-ASK-4-MET
(1-800-275-4638).
Enrolling Rehired Employees
Any rehired employee should be enrolled as if he or she were a new employee regardless of whether or not this person was previously covered under your group plan. The only exception is if the employee is rehired within six (6) months of the date on which coverage terminated because employment ended.
Any rehired employee returning from the armed services does not have to meet the requirements for coverage of your group plan. Please note on the Enrollment Application that the employee is returning from the armed services and the date he or she returned to full-time employment.
Effective Dates For Absent Employees
Individual effective dates for an employee who becomes eligible for benefits after the initial effective date of the employer's plan may be delayed if the employee is out due to injury or sickness on the date that benefits would be effective.
At initial enrollment, eligible employees who are not at work due to injury or sickness on the day benefits would normally become effective, will have benefits delayed until they return to work. Refer to your prior carrier's Certificate of Insurance for the extension of benefits section.
A late enrollment occurs when an Employee:
- Has chosen not to enroll himself or herself for coverage within 31 days of the eligibility date (See the applicable Certificate or plan document for more details) and decides to do so when offered at a later date
- Reapplies after termination of coverage at the Employee's request
- Applies for reinstatement upon returning to work after termination of employment, lay-off or leave of absence
- Applies for coverage and was previously eligible for coverage under the prior insurance carrier but did not enroll
Late Enrollments For Contributory Coverage
Employees who do not complete and submit Enrollment Forms during their enrollment period, and employees requesting amounts over the non-medical maximum (found in your Certificate of Insurance) must submit Statement of Health Forms in addition to Enrollment Forms. Coverage is subject to approval by MetLife. Effective dates for approved enrollments are determined by MetLife. Please see your Certificate of Insurance for more details.
If employee coverage was terminated at the employee's request, and the employee wants to re-enroll for coverage, a Statement of Health Form will be required in addition to the Enrollment Form.
Late Enrollments For Non-Contributory Coverage
All employees are to be covered on the date they are eligible. There are no late enrollments for non-contributory benefits.
Evidence of Good Health Requirements
With regard to Disability coverage, evidence of good health is required for late enrollments. Any proposed Insured can not receive coverage until proof of good health for himself or herself is approved. See Statement of Health Procedures in this section for instructions on completing and processing the required forms.
How to Submit Statement of Health Forms
Employers should treat all information in the Statement of Health Form as confidential. Information should not be discussed with, or disclosed to, others unless such discussion or disclosure is necessary to administer the MetLife coverage.
Review the employee's statement section of the form to ensure that all required questions have been answered and complete the employer section of the form. The original copy should be sent to MetLife. You should keep a copy for your records, and the employee should retain a copy for his/her records.
The authorization to furnish medical information is incorporated into the employee's statement. If necessary, it allows MetLife to request a medical examination and/or additional information from the employee's attending physician for the purpose of underwriting the coverages involved. The signature of the employee who is applying for coverage is always required.
Mail Statement of Health Forms to:
MetLife Statement of Health
P.O. Box 14069
Lexington, KY 40512-4069
Once the completed Statement of Health is received and reviewed by MetLife, the employer will receive notification of approval or declination. If a status has not been received within three weeks of submitting the Statement of Health, contact Customer Service at 1-800-ASK-4-MET (1-800-275-4638). Please do not have the employee call.
The Statement of Health Form may require employees to disclose sensitive medical information about themselves. This information is used exclusively for determination of insurability. It is not to be used or made available for any other purpose whatsoever.
Examples of Changes in Employee Status
Examples of changes that require notification include:
- Employee has a change in earnings or occupation that affects benefit amounts.
- Employee cancellation of a contributory coverage.
- Employee changes benefit class.
- Employee changes name.
- Employee divorce or legal separation.
- Death of employee.
MetLife must be notified of any change in employee classification or salary to ensure maximum benefits are paid at time of claim. You may indicate the changes on a written list. The listing must include the group name and number, employee's name, effective date of the change and the employee’s Social Security number.
The Change Request Form may be used for all other changes.
Examples of employee coverage terminations that require notification include:
- Employee has been terminated.
- Employee no longer meets the definition of an eligible employee under the plan.
- Employee stops making contributions.
An employee's coverage may be continued even though he or she may not be actively at work under the following conditions:
- During a temporary layoff; or
- During an authorized leave of absence.
Continuing coverage in these situations is an option you should consider only when the reasonable expectation exists that the employee will return to work.
To continue coverage, the same contribution must be paid as if the employee was at work. The termination date for any employee continuing coverage under these conditions is the date employment actually terminates. Please indicate the employee's name and the date employment terminated on a Change Request Form.
For more information on the requirements and time periods for this type of coverage to continue, please refer to your Certificate of Insurance.
Temporary Layoffs Or Leaves Of Absence
For an employee who has been laid off or who has taken a leave of absence, certain coverages such as Life/AD&D and Dental may be continued as determined by the rules and practices of the employer, however, continuance cannot be longer than 2 months. In the event the leave qualifies under the Family & Medical Leave Act of 1993 (FMLA), the period cannot be longer than 12 weeks following the date the leave of absence began.
Continuation of STD/LTD coverages for such an employee, however, is determined solely by MetLife and not by the employer. Refer to your Certificate of Insurance for any applicable rules.
If the employee does not return to work, submit a Change Request Form noting the date benefits terminate. Refer to your Certificate of Insurance for further information.
Conversion Privilege or Portability Eligible Insurance
If your Disability plan includes the Conversion Privilege or the Portability Eligible Insurance and you have a non-disabled employee whose employment is terminating due to any reason except retirement, the employee may be eligible to purchase the Conversion Insurance if the employee has been an active employee for at least 12 consecutive months.
If you are not sure whether or not you have purchased this optional supplemental benefit, please contact us.
If you have purchased this optional supplemental benefit and have an employee that is requesting this benefit, please contact us so that we can initiate the application process.
Most policies are renewed annually. Renewal underwriting and pricing typically occur before your group’s anniversary.
About four months before this date, MetLife will contact you to verify the accuracy of the insured data shown on your premium statement according to your records. We ask that you verify this information 90 days prior to your renewal date. If we have not received it, we will follow up with you.
Having a current history of covered insureds facilitates accurate pricing of your coverage.
Census Requirements For Self-Administered Bill Type Option
MetLife evaluates performance of each group plan once a year. These evaluations may or may not result in rate changes. We review covered lives and demographic information, and therefore require updated census.
For cases using the Self-Administered bill option MetLife does not maintain employee level data. At the time of renewal, you must provide MetLife with a detailed census of all insureds each year 90 days prior to your renewal date. In addition, provide the percentage of premium contributed by the employer for each line of coverage.
The census must include:
- name and/or Social Security Number;
- date of birth;
- gender;
- occupation (for LTD or STD);
- salary (for LTD, STD or Life);
- class information (eligibility according to the schedule of benefits);
- dependent coverage (indicate participants and whether spouse or child) for all insureds;
- number of hours worked per week (for hourly employees);
- amount of coverage (by line of coverage); and
- total number of employees eligible.
- participants;
- amount of coverage;
- amount or percentage contributed by employer; and
- total number of employees eligible.
MetLife sends a renewal action letter prior to your group’s anniversary. The letter states the status of your plan and any renewal changes.
When Your Group Falls Below Participation Requirements
Your group plan may terminate if the participation falls below the required participation percentage noted in your Certificate of Insurance.
No changes can be made to your policy without advance approval from MetLife. To change your group policy, contact your group insurance representative or your local MetLife sales office. Be sure your request includes the proposed change, effective date and an authorized signature on company letterhead.
Once MetLife approves the change, you will receive an acknowledgment letter and, if needed, replacement policy and/or certificate forms.
Examples of policy modifications include changes in:
- Affiliates
- Class
- Employer contribution percentage
- Change of policy situs state
- Waiting period
- Elimination period
- Benefit level
Long Term Disability (LTD) coverage is designed to provide replacement of income to employees who, due to a long term disability, are unable to earn more than the amount specified in the plan or who are prevented from pursuing employment. These benefits are not expected to completely replace an employee’s predisability income, but rather a portion of that income.
When it looks like an employee's disability will extend beyond his or her elimination period, a claim needs to be filed. Claims should be submitted after the last date worked but as soon as possible to allow adequate processing time before the first benefit payment. Early notice also allows the earliest possible claim management. We recommend reporting the claim no later than 8 weeks prior to the end of the disabled employee's elimination period.
For groups where MetLife is your LTD carrier or administrator only, please provide your disabled employee with the MetLife LTD Claim Employee Statement and LTD Claim Physician's Statement forms. If it appears the employee’s disability will continue longer than 8 weeks prior to the end of the LTD Elimination Period, contact the employee to verify if he/she will be filing for Long Term Disability benefits. If so, you should complete the LTD Claim Employer Statement. We encourage employers to provide the completed Employer Statement to the employee so that all forms are submitted together. This not only reinforces the need for the employee to complete and submit their forms but, ensures that MetLife receives all the forms at the same time. The employee will also need to arrange for his/her doctor to complete the Attending Physician's portion of the form.
The employee needs to mail or fax the completed claim forms approximately 8 weeks before the waiting period expires to:
MetLife Disability
P.O. Box 14590
Lexington, Kentucky 40511-4590
OR
Fax to:
1-800-230-9531
If MetLife insures your STD plan or administers your STD or Salary Continuance plan, there is no need to submit an LTD application.
Whether your group has only LTD with MetLife or STD and LTD with MetLife, if additional information is required to evaluate the claim the employee will be contacted by phone to be advised of the information required. MetLife will pursue any additional information required to evaluate the claim however, it is the employee's responsibility to ensure all required information is submitted. When a claim decision is made, the employee is notified by phone and in writing. The employer will be notified of the decision in writing.
Disability Claims and MetLinkMetLink users can file and view disability claims. MetLink allows users to search claim information by employee name, employee social security, claim status or claim number.
Log into MetLink and click on the Claims section.
For further help navigating through the MetLink Claims section, access the Resources tab on MetLink to view your customized user guide.
Employees can access their Disability claims on MyBenefits. MyBenefits allows employees to receive alerts on any processed claims, view claim status and payment issue dates; as well as, file a new disability claim within 5-10 minutes.
To view a demo of MyBenefits, contact your MetLife Representative or Broker.
For New Mexico Residents only:
New Mexico Notice of Confidential Abuse Practices
This form permits victims of domestic violence to participate in a location confidentiality program as provided under the New Mexico Domestic Abuse Insurance Protection Act.
Other state requirements may apply.
MetLife offers support and incentives to claimants to return to work. Rehabilitation services may include coordination of return to work, identification of accommodations that would allow the employee to return to work, evaluation of the employee’s potential to perform other occupations if unable to perform his or her own occupation, assistance with a job search or other appropriate services. MetLife considers a number of factors when determining whether or not a disabled individual is a suitable candidate for rehabilitation.
These factors include: the extent and nature of the disability, the amount and duration of benefits, the individual's abilities, the individual's education, training and experience, and the individual's motivation to return to work.
Early identification and referral for rehabilitation is important, because the chances for return-to-work are increased when a claimant is contacted in the early stages of disability. The employer’s support of return to work and rehabilitation programs can play an important role in the successful return to work of disabled employees.
Our standard certificate language provides several incentives to employees for return to work. Please contact your MetLife representative to learn more about these incentives.
All submitted claims are reviewed for rehabilitation potential by the claims approvers and/or on-site vocational rehabilitation consultants.
Social Security Assistance Program
If it appears that an Employee may be eligible for Social Security Disability Insurance Benefits (SSDIB), MetLife will send an information packet to the Employee that explains the advantage of SSDIB and advises the Employee to apply. The packet includes:
- An explanation of the SSDIB application process
- An SSDIB Question & Answer document
- The Agreement Concerning Long Term Disability Benefits
form – this form explains that SSDIB benefits will reduce an LTD benefit and if the employee receives an SSDIB award, part or all of any retroactive SSDIB benefits are payable to MetLife. - An Authorization to Secure Award or Disallowance Information form – this form allows MetLife to contact the Social Security Administration to obtain the status of the employee’s application for benefits.
Appeals on Denial of Initial SSDIB Application
Initial denial of an SSDIB application can be appealed administratively and judicially. Because the rate of approvals on previously denied SSDIB applications is very high, MetLife encourages aggressive appeal of denials.
MetLife monitors the Employee's progress in the Social Security Appeals process. To encourage and assist the Employee in the appeals process, a MetLife Social Security Specialist contacts the Employee to discuss how MetLife can help including assistance with submission of medical documentation or referral to attorneys or vendors for assistance with the application process.
Social Security Disability Award Recoveries
Retroactive Social Security Disability Insurance Benefits (SSDIB) award situations need special attention. MetLife's standard contract requires employees to appeal SSDIB denials to the highest levels, when appropriate, and many initial denials of SSDIB are reversed upon appeal. When SSDIB is awarded after appeals, there is usually a lump sum payment representing retroactive SSDI benefits. These are an offset to the disability benefits paid by MetLife, which means an overpayment of MetLife benefits results. It is important to give immediate attention to the recovery of that overpayment of MetLife benefits.
A Reimbursement Agreement signed by the claimant will be maintained in the claim file. The Reimbursement Agreement acknowledges that it is the claimant's responsibility to make appropriate refunds if SSDIB benefits are awarded on a retroactive basis.
With HIPAA regulations, medical professionals and treatment providers are required to guard the confidentiality of claim information. To do so, most treatment providers require an authorization signed by their patient before they will provide requested medical information to insurance companies for the purpose of claim evaluation. Therefore, MetLife requires an up to date signed authorization from claimants so that, we may stay abreast of medical treatment and status relative to disability claim eligibility.
Additionally, to protect claimant's confidentiality, the LTD claims office uses the following guidelines:
- We consider all medical information confidential. We do not give this information to claimants, claimant representatives, or employers.
- We instruct claimants to contact their physicians whenever questions arise about a medical diagnosis
Benefit Payments by Electronic Funds Transfer
The MetLife LTD Claim payment system has a feature to provide an electronic funds transfer (EFT) option to LTD claimants receiving monthly benefits. If selected, EFT will electronically deposit all monthly benefit payments into the claimant's checking or savings account. This payment method will eliminate lost, stolen or delayed checks. Upon approval of a claim, the claimant will be sent information on this option including instructions on how to establish this service.
For Details regarding Tax Information click here.
The Internal Revenue Code (IRC) specifically addresses withholding and reporting of disability benefits paid by a "third party" (e.g., an insurer or 501(C)(g) trust). If the plan is contributory (where employees “contribute” part or the entire insurance premium), the employer's report to the employee and to the IRS must show the portion of benefits attributable to employee contributions (i.e., included in gross income).
By law, the employer must report the amount of benefits paid attributable to employee/employer contributions to both the employee and the IRS. The employer is the only party in possession of sufficient information to ascertain not only the net premium or net cost of the Plan, but also the total employee contributions actually paid during the periods involved. As such, the responsibility for determining the allocation rests with the employer.
Premium payments normally required for the employee toward the cost of Long Term Disability coverage will be waived during any period of disability for which a monthly LTD benefit is payable. Premium payments must continue during the Elimination Period.
Long Term Disability (LTD) and Life Coverages
When an employee's Life Insurance coverage ends due to total disability, that employee, after satisfying the waiting period requirement, may be entitled to a continuation of his or her Life Insurance coverage without premium payment under the Continued Protection (CP) provision of the Life Insurance Plan. The employer and employee each complete and submit a single claim form to initiate both the LTD and the Life Waiver of Premium claims.
The employer completes the Life Waiver Claim Form for Long Term Disability and Life Benefits Employer form. The employee will complete the Life Waiver Claim Form for Long Term Disability and Life Benefits Employee form and also provides the Attending Physician Statement form to his/her doctor for completion and submission to MetLife. The employer, employee and doctor must mail the completed forms to the MetLife designated PO Box. Once, the forms are received by MetLife, they will be reviewed by LTD and Life Waiver of Premium Case Managers. You will receive letters acknowledging receipt of the claims. Once the Life Waiver of Premium claim is near the end of the waiting period, the claim will be reviewed to determine if a claim decision can be rendered or if additional information needs to be requested.
- Life Waiver Claim Form for Long Term Disability and Life Benefits Employee
- Life Waiver Claim Form for Long Term Disability and Life Benefits Employer
If Life Insurance coverage and STD and/or LTD coverage is with MetLife, submit to:
MetLife Disability
P.O. Box 14590
Lexington, KY 40511-4590
If Life Insurance coverage and NO STD and/or LTD coverage is with MetLife, submit to:
MetLife Disability
P.O. Box 14631
Lexington, KY 40511-4590
ERISA is an important federal law that governs most benefit plans established and maintained by employers. It imposes among other things certain participant reporting requirements on an employer. As a service to employers, MetLife can include an "ERISA Information" statement with the certificates of insurance issued to a group. This statement, combined with a certificate of insurance, is intended to assist you in meeting ERISA’s requirement to provide a summary plan description (SPD) to participants describing the insurance benefits provided by MetLife under the ERISA plan. If you want the ERISA Information for your plan sent to you, please send a written request to us. Your request must include your MetLife group number, the name, address, and phone number of the plan administrator of your plan, the employer identification number (which may be your Federal Tax Identification Number), and the beginning and end date of your Plan's fiscal year.
NOTE: It is the employer's legal responsibility to comply with any subsequent updates or filings that the law requires. ERISA confers substantial law enforcement responsibilities on the Department of Labor Non-compliance with the law may result in certain civil or criminal penalties to an employer. We have included some general information about ERISA, however, we urge employers to obtain advice from their own legal and tax advisors concerning any obligations they may have under this law.
What Is ERISA?
ERISA is a federal law that governs most employer established welfare benefit plans (government and church plans are excluded as well as some employee pay all plans). It is the employer's responsibility to provide certain information to plan participants and the Department of Labor and comply with other requirements.
What types of employer groups are governed by ERISA?
This law generally applies to any employee welfare benefit plan that is established or maintained by:
- Any employer engaged in commerce or in any industry affecting commerce, or
- Any employee organization(s) representing employees engaged in commerce that provides certain benefits to their employees, participants, dependents, or beneficiaries.
Welfare benefit plans may include plans that provide the following types of benefits:
- medical, dental, disability income, or life benefits
- unemployment, vacation or severance benefits
- other types of employer sponsored benefits.
Is there a minimum number of employees below which ERISA does not apply?
No. ERISA governs all welfare benefit plans that have one or more employees, unless they are church or government groups.
What does ERISA require employers to do?
Generally, ERISA requires all employers (or plan administrators as an employer may contract with) to provide participants and beneficiaries with a summary plan description (SPD) describing in understandable terms their rights, benefits and responsibilities under the plan. Employers are also required to furnish participants with a summary of any material changes to the plan or changes to the information contained in the summary plan descriptions. These documents must be furnished to the Department of Labor on request.
Employers with 100 or more participants must file a Form 5500 annually. Employers with fewer than 100 participants must file Form 5500-C at least every third year and Form 5500-R in the two intervening years.
Where can I obtain additional information about ERISA?
You should contact your legal and tax counsel to advise you about your obligations as an employer under this law. You may also contact The Department of Labor or visit their web site at www.dol.gov for more information.
ERISA Plan Number
Welfare Benefit Plans must start with 501.