SPD Questionnaire | HR & Compliance | The Small Business Association of Michigan

Summary Plan Descriptions

Summary Plan Descriptions


Summary Plan Descriptions are required by law.  Our document will keep you out of trouble with the DOL. 

Every employer with one or more employees that provides a group benefit plan (health, life, disability, dental or vision) is required by law to prepare and distribute a Summary Plan Description (SPD) to all covered employees. 

Convenient & Simple



An SPD describes the rights and responsibilities of both the employer and employee under the group benefit plan by providing detailed information about the health plan itself.  SBAM can help you become and stay compliant by providing you with a completed SPD.  We will gather the necessary information and place it into a customized SPD. We’ll send the completed SPD to you for review and then you can distribute it to your employees along with any other benefit booklets given to you by the provider. SBAM allows you to take care of your responsibility of providing an SPD with no hassles.

If your company is enrolled in an SBAM-sponsored BCBSM or BCN plan, we will provide you with a customized Summary Plan Description (SPD) at no cost.  

Simply submit the following three items to Kellie Neirynck (kellie.neirynck@sbam.org) in an email as an attachment: 

1. Completed SPD Questionnaire (click to download)
2. Copy of your Summary of Benefits and Coverage (SBC)
3. Copy of Benefits At A Glance for any additional plans you're enrolled in.  

If you have any questions, Kellie can be reached at (800) 362-5461 ext. 206.
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Within the questionnaire is a field regarding eligible participants. For 2 - 49 full-time equivalent employees (FTE), no further information is needed other than the number.  If you have 50 or more FTE please let us know the eligibility for part-time, variable-hour employees or seasonal employees.  If your company is using a look-back measurement period(s) as an eligibility rule for your plan, please email that employee eligibility language directly to Kellie. 

For the 50+ FTE:
  • Eligible Participants - Full-time employees must work ___ hours. 
  • Part-time, variable hour or seasonal employees:  Is your company using a look-back measurement period(s) as an eligibility rule for your plan?  If yes, please provide the employee eligibility language currently being used. 

Standard Language: 

With respect to part-time, variable hour or seasonal employees, coverage will be offered for a stability period of 12 months as follows:

1. During your first year of service,  if your average weekly hours of service equals 30 or more during the 12 months beginning on the first day of the month following your date of hire, you will be eligible for coverage beginning the first day of the thirteenth full month following your first day of work, and

2. Unless otherwise required under Affordable Care Act regulations, for each year thereafter, your eligibility for coverage will be determined using standard 12-month measurement periods ending each year on October 15. If your average weekly hours of service equals 30 or more during a standard measurement period, you will be eligible for coverage beginning the January 1st immediately following the end of the measurement period.  

Married participants that are both employed by the Employer may elect to be covered as either an employee or a covered dependent under this plan but not both. 

An employee who is also eligible for coverage as a dependent child may elect to be covered by this plan as an employee, or as a covered dependent but not both.