cjmazur
May 26 2009, 04:28 AM
Does anyone here have any insight to establishing and admisistrating a Self funded disability policy?
Fiduciary Guidance Counsel
May 26 2009, 07:03 AM
I wrote one last summer.
An important step is to be extra careful in how the summary plan description states the benefit. Assume that a court would find that a participant may rely on the SPD. And assume that a court might construe every ambiguity in a way that finds a benefit.
Focus on building a solid and clear claims procedure, and do it understanding that the employer has conflicting interests between deciding benefits and preserving its money.
fender5150
Jun 1 2009, 02:00 PM
Is anyone aware of a service that provides affordable prototypes for benefits like this?
J Simmons
Jun 6 2009, 02:53 PM
Don't know of a source for affordable prototypes for self-funded disability benefits.
However, I would begin drafting with a disability insurance policy as the model (making sure that I get permission from the copyright holder first).
This is the type of benefit you might want to have the plan's governing document and SPD be one and the same document.
Fiduciary Guidance Counsel
Jun 6 2009, 06:40 PM
Using the summary plan description as the only writing that states the plan is the method that I've used.
An employer that bears the financial consequences of a mistake or ambiguity in the written plan might consider that using a "prototype" provider leaves it with no one to share the consequences of inexactness.
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