Does ERISA's requirement to provide SMM for material reduction on accelerated basis (within 60 days) apply to excepted benefit dental plan?

[ERISA guy]

Title

[Brian Gilmore]

Yes.  Excepted benefit status is relevant for HIPAA portability/ACA market reforms.  It's not relevant for the ERISA rules, which require an SMM within 60 days of adoption of a material reduction in group health plan benefits.  A material reduction in dental/vision (regardless of excepted benefit status) qualifies for this purpose as a group health plan.

More details:

• https://www.newfront.com/blog/when-to-distribute-an-updated-wrap-spd
• https://www.newfront.com/blog/aca-and-hipaa-excepted-benefits

Cite:

https://www.govinfo.gov/app/details/CFR-2022-title29-vol9/CFR-2022-title29-vol9-sec2520-104b-3

(d) Special rule for group health plans.
(1)  General.
Except as provided in paragraph (d)(2) of this section, the administrator of a group health plan, as defined in section 733(a)(1) of the Act, shall furnish to each participant covered under the plan a summary, written in a manner calculated to be understood by the average plan participant, of any modification to the plan or change in the information required to be included in the summary plan description, within the meaning of paragraph (a) of this section, that is a material reduction in covered services or benefits not later than 60 days after the date of adoption of the modification or change.

 

Slide summary:

Newfront Office Hours Webinar: ERISA for Employers