By The Numbers Plan Documents

Plan documents by the numbers: what self-funded employers should look for in summary plan descriptions, stop loss policies, and TPA contracts.
A pair of eyeglasses resting on a printed document.

By Book Chrobak, Health Analytics Manager

 


 

Switching to self-funding health benefits allows employers to take control of their costs, design their benefit coverages, and understand their healthcare spend. The plan document is the “formal, written, legal statement listing the provisions of the insurance plan.” It is the instrument that sets forth the benefit details and all other conditions of coverage. In short, it’s rather important.

 

Plan documents are also rather long. The average plan document page length for groups in the Roundstone program is 94 pages. The longest is over 120 pages. Roundstone, as a self-funded employer itself, has a 77 page plan document. It is the longest legal document our company is a party to, which is likely the case for most program participants.

 

The importance of plan documents can be at odds with the intimidating length. Plan documents should be reviewed and updated regularly, but it can feel like a daunting undertaking in light of the length and “legalese.” Nevertheless, spending time to review and compare your group’s plan document will help identify any gaps, confirm that your company is administering the plan correctly, update for legal changes, and ensure benefits that match your intentions. Roundstone is available to work with you and your advisor on this vital review.

 

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Roundstone Team
Founded in 2003, Roundstone came together because of a shared belief that they could help employers adopt a different approach and positively impact bottom-line results.

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