retirees of a large industrial manufacturer could not rely on ERISA for substantive protection of the health and other welfare benefits that the company terminated in bankruptcy.53 Likewise, the parents of a hospitalized child could not acquire a vested expectation to full payment for the hospital admission if health plan trustees properly reduced coverage and payment levels during the course of the admission. 54 In sum, the federal courts look at the private contract between employer and employee to provide health benefits and conclude that nothing in ERISA regulates the terms of that contract with respect to its modification or termination.
ERISA articulates detailed reporting and disclosure requirements for employee benefits. These requirements apply unevenly to welfare plans and pension plans because the latter are required to furnish to the Secretary of Labor considerable additional information.55 With respect to welfare plans, three basic requirements sum up ERISA's disclosure and reporting provisions, although the details may be quite complex and vary for different kinds of plans.
First, welfare plans must periodically furnish to participants and beneficiaries a summary plan description.56 The Secretary of Labor has added by regulation a requirement that the description explain what medical benefits are covered by the plan.57 Second, the administrator of a welfare plan must file with the Secretary of Labor the summary plan description and must also file material modifications to the plan.58 Third, plan participants must be furnished with a summary annual report.59 In addition, plans with more than 100 participants, and certain others, must file an annual return (form 5500), which may include detailed financial information, with the Internal Revenue Service.
The summary plan description is the primary disclosure document about the plan that is made available to participants and their beneficiaries. Reflecting congressional concern, ERISA states that the summary plan description "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 of their rights and obligations under the plan."60 Plans that are fully insured and have fewer than 100 participants are exempt by regulation from the annual reporting requirements. Depending on their financing arrangements, other plans face reporting requirements of varying complexity. The procedural character of the reporting and disclosure requirements in ERISA is apparent from the text of the statute and implementing regulations.
ERISA requires that the following information be included in the summary plan description: