You will be solely responsible for complying with all applicable provisions of the Employee Retirement Income Security Act of 1974, as amended (ERISA). This includes the fiduciary responsibilities of administering your benefits plans, maintaining adequate funding to support these plans and providing required notices to Members.
Attached are the Blue Cross Blue Shield of Massachusetts Subscriber Certificate(s) and associated riders for your health plan. While the Subscriber Certificate(s) and riders provide complete and detailed benefit information, they may not include information that you, as the sponsor of a group health plan, may need to comply with your statutory or regulatory notice obligations under ERISA or other applicable law. For example, these documents may not include all the information required under ERISA to be in a "summary plan description". In addition, these documents do not constitute a complete Evidence of Coverage as defined under Massachusetts state law and regulations.
Each employer that sponsors an ERISA welfare benefit plan is responsible for creating a summary plan description, or SPD, for its employees. ERISA regulations require employer groups to provide their employees with SPDs that include information regarding any health plan being offered through a federally qualified HMO, as well as additional employee benefits or rights. As an employer's health plan, Harvard Pilgrim provides its standard evidence of coverage (EOC) and other member materials to enrollees. While these documents include specific coverage details, like the Summary or Schedule of Benefits, they are not customized to include the group-specific information that employers are required to include in SPDs. Upon request, Harvard Pilgrim can assist employers by providing some of the documents that make up the SPD, such as the Summary or Schedule of Benefits and Benefit Hand- book. However, there are many ERISA requirements for an SPD that are specific to the employer and its non-Harvard Pilgrim benefits. As such, it is the employer's responsibility to put together a comprehensive SPD for its employees. Harvard Pilgrim urges employers to consult with their own benefits counsel to ensure compliance with this complex set of rules.
Excerpt from Anthem BCBS of New Hampshire, Inc. Fully Insured Master Contract. Page.8
5.6 The Employer or its designated Plan Administrator shall retain fiduciary responsibility for compliance with any and all applicable federal, state and local laws and regulations. This includes, but is not limited to, the provisions and documentation to be delivered to Members as required by COBRA and as required by other provisions of the Employee Retirement Income Security Act of 1974, as amended ("ERISA").