Effective Dates for SPD and claims procedure regulations

[Guest wendycatherine]

What are the effective dates for SPD and claims procedure regs?

SPD regs are "applicable as of the first day of the second plan year beginning on or after 1/22/01 = 1/1/03 for calendar year plans. So, do SPDs need to be updated and distributed by that date? Some have interpreted that there are 210 days after that time to get SMM or SPD out. This sounds nice, but doesn't make sense to me. For example, if an SPD has to have a statement that QDRO procedures are available, how does the rule that you get "210 days after the close of the plan year in which the modification was adopted" fit? It is not really a modification being adopted, but an additional requirement imposed by the DOL.

Also, for calendar year retirement plans, claims procedures are effective 1/1/02, health plans, 1/1/03. Do the procedures need to be reflected in the SPD at the same time as above? What about in the plan document?

[E as in ERISA]

The claims regs contain substantive rules about claims procedures that have to be followed by the "applicable date." The regs provide that the procedures have to be included in the SPD. The commentators are saying that the "applicable date" applies to the substantive rules, and that the normal 210 rule applies to the SPD requirement. (I believe that this is different than the new QDRO requirement -- which was not a change in the substantive requirement -- just a requirement to add it to the SPD).

[Guest wendycatherine]

Thanks for your reply, Katherine. Are you saying new claims procedures must be in SPD by 210 days after the year they went into effect, but other requirements such as stating that QDRO procedures are available must be in the SPD immediately? Seems strange.

[E as in ERISA]

I don't know the answer. Hopefully someone else can comment.

I believe that this article, "Claims Procedures For Pension Plans Providing Disability Benefits" suggests that the 210-day rule applies to the claims procedures in an SPD: www.jenkens.com/jenkens/newsletters/BIB/bib_v4i1.pdf

I believe that this article suggest that the SPD had to be changed by the applicable date: http://www.ebia.com/weekly/questions/2002/...RISA020703.html

If the first author is correct, then I believe that the distinction lies in the fact that the claims regulation change is a substantive change and the QDRO change was a change to the SPD rules themselves.