Below are three key notes to learn as you approach the upcoming Open Enrollment Season:
1. If the Open Enrollment (OE) materials include required ERISA language, they may serve as a Summary of Material Modifications (SMM), which is an ERISA-mandated notice that must be distributed to plan participants.
This can streamline compliance because OE materials are typically already scheduled for distribution. In most cases, distribution* is completed electronically. (See #3 for additional information.)
What ERISA language should be included in your OE materials to have it serve as a SMM?
If the materials include a section on “What’s Changing for the New Plan Year,” a box at the top** of this section could be added that states:
| This section constitutes a Summary of Material Modifications (SMM) to the Summary Plan Description (SPD) for the Plan, thereby modifying the information previously presented in the SPD with respect to the Plan. Please keep a copy of this SMM with the SPD previously provided to you. |
* Under ERISA, SMMs are required to be distributed within 210 days after the end of the plan year in which the change is adopted or, if the change is a material reduction in covered services or benefits, no later than 60 days after the date of adoption of the reduction. If the OE materials are used more than likely this will be ahead of these timeframes.
** ERISA mandates that for plan participants to see the material clearly. ERISA materials should not be listed as fine print at the bottom of the page.
2. Updated Medicaid and CHIP Premium Assistance Model Notice Available
The U.S. Department of Labor has released an updated Medicaid and CHIP Premium Assistance Model Notice, effective July 31, 2026. The revised notice is available here:
https://www.dol.gov/sites/dolgov/files/ebsa/laws-and-regulations/laws/chipra/model-notice.pdf
The update adds Illinois to the list of states offering premium assistance and revises the state-specific information and labeling for Colorado. Employers should review the updated notice and incorporate it into their annual CHIP notice distribution processes, as applicable.
3. There are specific notes to apply to distribute Summary Material Modification (SMM) and Summary Annual Report (SAR) for Current Employees that are often part of OE packets:
Per ERISA Plan sponsors should ensure the materials are furnished by a method “reasonably calculated to ensure actual receipt.” For electronic distribution, this can be accomplished using email with return receipt enabled or by adding a confirmation-of-receipt checkbox to a website. Otherwise, keeping a Distribution Log is considered good practice.
Distribution Methods Depend on an Individual’s Computer Access
Active Employees: Options for those WITH Computer Access at Work (does not include kiosks)
- By email with return receipt enabled and the SMM/SAR is attached
- By email with return receipt enabled and a link to the SMM/SAR uploaded to an employee website
- By email with confirmation of receipt checkbox enabled on the website
- By printed communication to all applicable employees that includes the URL address to the SMM/SAR and a confirmation of receipt checkbox enabled on the website
Note that the above electronic distribution methods only work for active employees.
Active Employees & Other Recipients: Options for those WITH NO Computer Access at Work
- With Signed Consent on file – by email with return receipt enabled and the SMM/SAR attached
- With Signed Consent on file – by email with return receipt enabled and a link to the SMM/SAR uploaded to an employee website or other website accessible to non-employees
With Signed Consent on file – by printed communication that includes the URL address to the SMM/SAR and a confirmation of receipt checkbox enabled on the website.
| Posting the SMM and SAR on the Company Website for Current Employees |
Placing the SMM or SAR on a company website will satisfy the electronic distribution rules if the plan administrator:
- Uses appropriate and necessary means to ensure that posting these documents on a company’s website results in actual receipt;
- Provides a written or electronic notice to employees directing them to the website, at the time the document is posted, and describing the documents’ significance and the right to request a paper copy; and
- Provides a paper copy of the document on request without charge.
Taking “appropriate and necessary” measures to make sure the posting of SMMs and SARs on a company’s website results in actual receipt could include:
- Adding a prominent link from the website’s homepage to the separate section that contains the document;
- Providing directions on the website for how to replace a lost or forgotten password to the extent one is needed; and,
- Maintaining the documents on the website for a reasonable period of time following notice to employees of their availability.
- Website Retention: Per DOL guidance, ERISA disclosures posted to a website for participant review should remain on the website until superseded by a subsequent version, but in no event less than one year.
For questions on this material, feel free to reach out to Ann McAdam, Project Manager at info@wrangle5500.com