Compliance Reminder:
ERISA is a complex federal law, and employers should always seek guidance from qualified ERISA counsel when applying these rules to their own benefit plans. This content is provided for informational purposes only and does not constitute legal advice.
Overview
ERISA requires every covered employee benefit plan to be established and maintained pursuant to a written instrument. This written instrument is commonly referred to as the Plan Document.
The Plan Document is the plan’s legal foundation – it defines how the plan operates, who is eligible, what benefits are offered, how contributions work, and how claims are processed. It serves as the official rulebook that the plan sponsor and administrator must follow, as required by federal law.
Employers of all sizes are required to have Plan Documents for each ERISA-covered benefit plan they offer. Without them, the employer is out of compliance and risks exposure during an audit or employee dispute.
Purpose of the Plan Document
The Plan Document exists to:
- Establish the plan’s existence under ERISA.
- Define the terms and conditions governing eligibility, benefits, and administration.
- Outline the allocation of authority and fiduciary responsibility between the plan sponsor and administrator.
- Provide a legal defense in the event of disputes or DOL audits.
The Plan Document is kept on file for reference and audit purposes and is not routinely distributed to employees or plan beneficiaries. However, if a participant or beneficiary submits a written request for the document, the employer must provide it within 30 days. Failure to do so may result in participant-initiated penalties of up to $110 per day, and failure to produce documents requested by the Department of Labor can trigger separate DOL penalties of up to $195 per day (2025 indexed).
Required Content
ERISA does not dictate a single format, but the Department of Labor (DOL) and courts expect a compliant Plan Document to include, at minimum:
- Plan name, type, and effective date
- Plan sponsor and administrator information
- Eligibility and participation rules
- Description of benefits provided
- Funding method (employer, employee, or both; pre-tax, post-tax)
- Claims and appeals procedures (may cross-reference a separate document)
- Plan amendment and termination provisions
- Fiduciary authority and responsibilities
- Procedures for allocation of assets if the plan terminates
- Statement of ERISA rights and governing law
While some of these details may overlap with what appears in the Summary Plan Description (SPD), the Plan Document is a legal document designed for compliance and operational reference, not for everyday employee communication.
Who Creates It
For fully insured benefit plans, the insurance carrier’s policy or certificate of coverage does not serve as a complete ERISA Plan Document. These materials describe the terms of the insurance contract, not the employer’s ERISA plan. They typically omit required information such as fiduciary designations, claims appeal procedures, and plan amendment rules.
Because of this, the employer – as the plan sponsor – is responsible for creating and maintaining the ERISA Plan Document.
The employer’s Plan Document should:
- Incorporate the carrier’s certificate or policy by reference to describe covered benefits; and
- Add the missing ERISA-required provisions, such as eligibility rules, funding methods, fiduciary designations, and amendment procedures.
For self-funded plans (including HRAs), the employer must maintain a standalone Plan Document that reflects the plan’s specific structure, funding, and administrative procedures. These are typically drafted or reviewed by ERISA counsel or a qualified compliance consultant.
While health insurance brokers are not legally responsible for producing or maintaining ERISA Plan Documents, they play a critical role in helping employers understand the requirement, identify compliance gaps, and connect them with trusted ERISA documentation resources.
In short, carriers issue insurance contracts, brokers educate and guide, and employers establish the plan – with the Plan Document serving as the formal written proof of that obligation.
Common Employer Misconceptions and Pitfalls
Many employers mistakenly believe their insurance contracts or SPDs are Plan Documents. In reality:
- An insurance policy describes the coverage, not the full ERISA plan.
- An SPD summarizes the plan for employees but is not a substitute for the official written plan instrument.
- Employers must have both – the Plan Document for compliance and the SPD for disclosure.
Failing to maintain a proper Plan Document can result in:
- DOL penalties of up to $195 per day (2025 indexed) for failure to produce upon request.
- Inability to defend plan administration decisions.
- Exposure in participant lawsuits over eligibility, claims, or fiduciary conduct.
Best Practice
Every ERISA-covered benefit should have its own Plan Document or be included in a wrap plan document that consolidates multiple benefits under one governing plan.
Having written, up-to-date Plan Documents:
- Demonstrates compliance with ERISA Section 402(a).
- Reduces audit and litigation risk.
- Ensures consistency between plan administration and employee communications.
- Provides a clear foundation for the SPD and other required disclosures.
Key Takeaway
The Plan Document is not optional. It is the legal backbone of every ERISA plan – establishing how the plan operates, protecting the employer from risk, and defining the rights of plan participants.
Employers that offer benefits without maintaining written Plan Documents are still subject to ERISA but are out of compliance with one of its most fundamental requirements.