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29 U.S.C. § 1022 — Summary plan description

Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1022 — Summary plan description

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Stable record: federal_law:legal_authorities:record_usc_12a9a1e71142a8ca0f3a2d41
Source file: Laws/federal/codes/united-states-code/title-29/section-1022-summary-plan-description--bc6ee20175.md
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Source location: Title 29, Chapter 18, § 1022; chapter-018-employee-retirement-income-security-program.md

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**(a)** A summary plan description of any employee benefit plan shall be furnished to participants and beneficiaries as provided in [section 1024(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1024/b&num=0&edition=prelim). The summary plan description shall include the information described in subsection (b), shall be written in a manner calculated to be understood by the average plan participant, and shall be sufficiently accurate and comprehensive to reasonably apprise such participants and beneficiaries of their rights and obligations under the plan. A summary of any material modification in the terms of the plan and any change in the information required under subsection (b) shall be written in a manner calculated to be understood by the average plan participant and shall be furnished in accordance with [section 1024(b)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1024/b/1&num=0&edition=prelim). **(b)** The summary plan description shall contain the following information: The name and type of administration of the plan; in the case of a group health plan (as defined in [section 1191b(a)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1191b/a/1&num=0&edition=prelim)), whether a health insurance issuer (as defined in [section 1191b(b)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1191b/b/2&num=0&edition=prelim)) is responsible for the financing or administration (including payment of claims) of the plan and (if so) the name and address of such issuer; the name and address of the person designated as agent for the service of legal process, if such person is not the administrator; the name and address of the administrator; names, titles, and addresses of any trustee or trustees (if they are persons different from the administrator); a description of the relevant provisions of any applicable collective bargaining agreement; the plan’s requirements respecting eligibility for participation and benefits; a description of the provisions providing for nonforfeitable pension benefits; circumstances which may result in disqualification, ineligibility, or denial or loss of benefits; the source of financing of the plan and the identity of any organization through which benefits are provided; the date of the end of the plan year and whether the records of the plan are kept on a calendar, policy, or fiscal year basis; the procedures to be followed in presenting claims for benefits under the plan including the office at the Department of Labor through which participants and beneficiaries may seek assistance or information regarding their rights under this chapter and the Health Insurance Portability and Accountability Act of 1996 with respect to health benefits that are offered through a group health plan (as defined in [section 1191b(a)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1191b/a/1&num=0&edition=prelim)), the remedies available under the plan for the redress of claims which are denied in whole or in part (including procedures required under [section 1133 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1133&num=0&edition=prelim)), and if the employer so elects for purposes of complying with [section 1181(f)(3)(B)(i) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/f/3/B/i&num=0&edition=prelim), the model notice applicable to the State in which the participants and beneficiaries reside.

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1191b — Definitions

**(a) Group health plan** For purposes of this part— (1) **In general** — The term “group health plan” means an employee welfare benefit plan to the extent that the plan provides medical care (as defined in paragraph (2) and including items and services paid for as medical care) to employees or their dependents (as defined under the terms of the plan) directly or through insurance, reimbursement, or otherwise. Such term shall not include any qualified small employer health reimbursement arrangement (as defined in [section 9831(d)(2) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section9831/d/2&num=0&edition=prelim)). (2) **Medical care** — The term “medical care” means amounts paid for— (A) the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body, (B) amounts paid for transportation primarily for and essential to medical care referred to in subparagraph (A), and (C) amounts paid for insurance covering medical care referred to in subparagraphs (A) and (B). **(b) Definitions relating to health insurance** For purposes of this part— (1) **Health insurance coverage** — The term “health insurance coverage” means benefits consisting of medical care (provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as medical care) under any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization contract offered by a health insurance issuer. (2) **Health insurance issuer** — The term “health insurance issuer” means an insurance company, insurance service, or insurance organization (including a health maintenance organ

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1191b

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29 U.S.C. § 1001 — Congressional findings and declaration of policy

**(a) Benefit plans as affecting interstate commerce and the Federal taxing power** The Congress finds that the growth in size, scope, and numbers of employee benefit plans in recent years has been rapid and substantial; that the operational scope and economic impact of such plans is increasingly interstate; that the continued well-being and security of millions of employees and their dependents are directly affected by these plans; that they are affected with a national public interest; that they have become an important factor affecting the stability of employment and the successful development of industrial relations; that they have become an important factor in commerce because of the interstate character of their activities, and of the activities of their participants, and the employers, employee organizations, and other entities by which they are established or maintained; that a large volume of the activities of such plans are carried on by means of the mails and instrumentalities of interstate commerce; that owing to the lack of employee information and adequate safeguards concerning their operation, it is desirable in the interests of employees and their beneficiaries, and to provide for the general welfare and the free flow of commerce, that disclosure be made and safeguards be provided with respect to the establishment, operation, and administration of such plans; that they substantially affect the revenues of the United States because they are afforded preferential Federal tax treatment; that despite the enormous growth in such plans many employees with long years of employment are losing anticipated retirement benefits owing to the lack of vesting provisions in such plans; that owing to the inadequacy of current minimum standards, the soundness and stabilit

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1001

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1181 — Increased portability through limitation on preexisting condition exclusions

**(a) Limitation on preexisting condition exclusion period; crediting for periods of previous coverage** Subject to subsection (d), a group health plan, and a health insurance issuer offering group health insurance coverage, may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if— (1) such exclusion relates to a condition (whether physical or mental), regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date; (2) such exclusion extends for a period of not more than 12 months (or 18 months in the case of a late enrollee) after the enrollment date; and (3) the period of any such preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage (if any, as defined in subsection (c)(1)) applicable to the participant or beneficiary as of the enrollment date. **(b) Definitions** For purposes of this part— (1) **Preexisting condition exclusion** (A) *In general* — The term “preexisting condition exclusion” means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date. (B) *Treatment of genetic information* — Genetic information shall not be treated as a condition described in subsection (a)(1) in the absence of a diagnosis of the condition related to such information. (2) **Enrollment date** — The term “enrollment date” means, with respect to an individual covered under a group health plan or health insurance coverage, the date of e

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1181

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1396 — Medicaid and CHIP Payment and Access Commission

**(a) Establishment** There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as “MACPAC”). **(b) Duties** (1) **Review of access policies for all States and annual reports** — MACPAC shall— (A) review policies of the Medicaid program established under this subchapter (in this section referred to as “Medicaid”) and the State Children’s Health Insurance Program established under subchapter XXI (in this section referred to as “CHIP”) affecting access to covered items and services, including topics described in paragraph (2); (B) make recommendations to Congress, the Secretary, and States concerning such access policies; (C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such reviews and MACPAC’s recommendations concerning such policies; and (D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, including the implications of changes in health care delivery in the United States and in the market for health care services on such programs. (2) **Specific topics to be reviewed** — Specifically, MACPAC shall review and assess the following: (A) *Medicaid and CHIP payment policies* — Payment policies under Medicaid and CHIP, including— (i) the factors affecting expenditures for the efficient provision of items and services in different sectors, including the process for updating payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of ot

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1396

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29 U.S.C. § 1003 — Coverage

**(a) In general** Except as provided in subsection (b) or (c) and in sections 1051, 1081, and 1101 of this title, this subchapter shall apply to any employee benefit plan if it is established or maintained— (1) by any employer engaged in commerce or in any industry or activity affecting commerce; or (2) by any employee organization or organizations representing employees engaged in commerce or in any industry or activity affecting commerce; or (3) by both. **(b) Exceptions for certain plans** The provisions of this subchapter shall not apply to any employee benefit plan if— (1) such plan is a governmental plan (as defined in [section 1002(32) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/32&num=0&edition=prelim)); (2) such plan is a church plan (as defined in [section 1002(33) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/33&num=0&edition=prelim)) with respect to which no election has been made under [section 410(d) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section410/d&num=0&edition=prelim); (3) such plan is maintained solely for the purpose of complying with applicable workmen’s compensation laws or unemployment compensation or disability insurance laws; (4) such plan is maintained outside of the United States primarily for the benefit of persons substantially all of whom are nonresident aliens; or (5) such plan is an excess benefit plan (as defined in [section 1002(36) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/36&num=0&edition=prelim)) and is unfunded. The provisions of part 7 of subtitle B of this subchapter shall not apply to a health insurance issuer (as defined i

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1003

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42 U.S.C. § 201 — Funding

Beginning with fiscal year 2010, the Secretary shall transfer from the Public Health and Social Services Emergency Fund such sums as may be necessary to carry out this part.

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1133 — Claims procedure

In accordance with regulations of the Secretary, every employee benefit plan shall— (1) provide adequate notice in writing to any participant or beneficiary whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial, written in a manner calculated to be understood by the participant, and (2) afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the appropriate named fiduciary of the decision denying the claim.

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1133

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29 U.S.C. § 1031 — Repeal and effective date

**(a)** (1) The Welfare and Pension Plans Disclosure Act [[29 U.S.C. 301](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section301&num=0&edition=prelim) et seq.] is repealed except that such Act shall continue to apply to any conduct and events which occurred before the effective date of this part. (2) (A) [Section 664 of title 18](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title18-section664&num=0&edition=prelim) is amended by striking out “any such plan subject to the provisions of the Welfare and Pension Plans Disclosure Act” and inserting in lieu thereof “any employee benefit plan subject to any provisions of title I of the Employee Retirement Income Security Act of 1974”. (B) (i) Section 1027 of such title 18 is amended by striking out “Welfare and Pension Plans Disclosure Act” and inserting in lieu thereof “title I of the Employee Retirement Income Security Act of 1974”, and by striking out “Act” each place it appears and inserting in lieu thereof “title”. (ii) The heading for such section is amended by striking out “welfare and pension plans disclosure act” and inserting in lieu thereof “employee retirement income security act of 1974”. (iii) The table of sections of chapter 47 of such title 18 is amended by striking out “Welfare and Pension Plans Disclosure Act” in the item relating to section 1027 and inserting in lieu thereof “Employee Retirement Income Security Act of 1974”. (C) Section 1954 of such title 18 is amended by striking out “any plan subject to the provisions of the Welfare and Pension Plans Disclosure Act as amended” and inserting in lieu thereof “any employee welfare benefit plan or employee pension benefit plan, respectively, subject to any provision of title I of the Employee Re

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29 U.S.C. § 1024 — Filing with Secretary and furnishing information to participants and certain employers

**(a) Filing of annual report with Secretary** (1) The administrator of any employee benefit plan subject to this part shall file with the Secretary the annual report for a plan year within 210 days after the close of such year (or within such time as may be required by regulations promulgated by the Secretary in order to reduce duplicative filing). The Secretary shall make copies of such annual reports available for inspection in the public document room of the Department of Labor. (2) (A) With respect to annual reports required to be filed with the Secretary under this part, the Secretary may by regulation prescribe simplified annual reports for any pension plan that— (i) covers fewer than 100 participants; or (ii) is a plan described in [section 1060(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1060/a&num=0&edition=prelim) that covers fewer than 1,000 participants, but only if no single employer in the plan has 100 or more participants covered by the plan. (B) Nothing contained in this paragraph shall preclude the Secretary from requiring any information or data from any such plan to which this part applies where he finds such data or information is necessary to carry out the purposes of this subchapter nor shall the Secretary be precluded from revoking provisions for simplified reports for any such plan if he finds it necessary to do so in order to carry out the objectives of this subchapter. (3) The Secretary may by regulation exempt any welfare benefit plan from all or part of the reporting and disclosure requirements of this subchapter, or may provide for simplified reporting and disclosure if he finds that such requirements are inappropriate as applied to welfare benefit plans. (4) The Secretar

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1024

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29 U.S.C. § 301 to 309 — Repealed. Pub. L. 93–406, title I, § 111(a)(1), Sept. 2, 1974, 88 Stat. 851

### Statutory Notes Section 301, Pub. L. 85–836, § 2, Aug. 28, 1958, 72 Stat. 997, set forth Congressional findings and policy with respect to welfare and pension plan disclosure. See [section 1001 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1001&num=0&edition=prelim). Section 302, Pub. L. 85–836, § 3, Aug. 28, 1958, 72 Stat. 997; Pub. L. 86–624, § 21(d), July 12, 1960, 74 Stat. 417; Pub. L. 87–420, §§ 2–5, Mar. 20, 1962, 76 Stat. 35, provided definitions for this chapter. See [section 1002 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002&num=0&edition=prelim). Section 303, Pub. L. 85–836, § 4, Aug. 28, 1958, 72 Stat. 998; Pub. L. 87–420, § 6, Mar. 20, 1962, 76 Stat. 35, related to plans covered within chapter. See [section 1003 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1003&num=0&edition=prelim). Section 304, Pub. L. 85–836, § 5, Aug. 28, 1958, 72 Stat. 998; Pub. L. 87–420, § 7, Mar. 20, 1962, 76 Stat. 36, related to duties of administrator and definition of “administrator”. See sections 1002(16)(A) and 1021 of this title. Section 305, Pub. L. 85–836, § 6, Aug. 28, 1958, 72 Stat. 999; Pub. L. 87–420, § 8, Mar. 20, 1962, 76 Stat. 36, related to time for publication and contents of plan. See [section 1022 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1022&num=0&edition=prelim). Section 306, Pub. L. 85–836, § 7, Aug. 28, 1958, 72 Stat. 1000; Pub. L. 87–420, §§ 9–13, Mar. 20, 1962, 76 Stat. 36, 37, related to time for publication, contents, etc., of annual reports. See [section 1023 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1023&num=0

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 301 to 309

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