SPD claims procedure

[Guest Hilarion]

A client has challenged the claims procedure language in our SPD. In researching this, the only cite I can find is to 29 CFR Sec. 2520.102-3(s), but this, apparently, only addresses the claims procedure for a group health plan. Can 29 CFR Sec. 2520.102-3(s) be relied upon for the SPD for a pension or profit sharing plan?

[QDROphile]

I don't understand your question.

The regulation you cite is the SPD requirment concerning the claims procedures, whether for pension plans or welfare plans. Guidance for the substance of claims procedures is at ERISA reg section 2560.503-1.

There is some uncertainty about whether the SPD regulations require the full articulation of the claims procedures be set forth in the SPD or in a document delivered with the SPD, or simply summarized (compare QDRO procedures, and see 2560.503-1(b)(2)). The safer course is be forthcoming with the entire written procedues in or with the SPD. The regulations do not actually say the all of the claims procedure must be in writing (again, compare QDRO procedures).