---
title: Section 105 Plan Document Requirements
description: Section 105 Plan Document Requirements. What the Section 105 Plan Documents are required to include, and why you need plan documents for Section 105 Plans.
---

[Personalized Employee Benefits Resources | PeopleKeep ](https://www.peoplekeep.com/blog)

# [Section 105 Plan Document Requirements](https://www.peoplekeep.com/blog/bid/324133/section-105-plan-document-requirements)

 Written by [Christina Merhar](https://www.peoplekeep.com/blog/author/christina-merhar) | January 9, 2014 at 6:30 PM

A Section 105 Plan allows tax-free reimbursement of medical and insurance expenses. The Section 105 Plan Document describes the terms and conditions related to the operation and administration of the Section 105 Plan.

## What is a Section 105 Plan?

The most common type of [Section 105](https://www.peoplekeep.com/section-105-plans) plan is a self-funded (or self-insured) health plan, where the employer self-funds (or self-insures) health benefits rather than pay premiums to an insurance company.

However, Section 105 Plans are also frequently found in the form of medical reimbursement plans such as [Health Reimbursement Arrangements](https://www.peoplekeep.com/health-reimbursement-arrangement-hra) (HRAs) and Healthcare Reimbursement Plans (HRPs).

A businesses might also implement a Section 105 Plan alongside a conventional [employer-sponsored health insurance](https://www.peoplekeep.com/blog/what-is-group-health-insurance) plan (to reimburse deductible amounts).

When discussing Section 105 Plan Document requirements in this article, we are focusing on Section 105 Plans used as a limited-purpose medical reimbursement plan (i.e. a Healthcare Reimbursement Plan or HRP).

## Section 105 Plan Documents must comply with IRS and ERISA rules

Section 105 Plans are subject to ERISA and therefore a legal Plan Document must be provided in writing. A Summary of Benefits is not considered an Plan Document or a Summary Plan Description (SPD). If a Section 105 Plan exists without a written Plan Document then it is out of compliance.

## A Section 105 Plan Document should contain the following: 

- Name of the Section 105 Plan Document Administrator

- Designation of any Named Fiduciaries other than the Plan Administrator under the claims procedure for deciding benefit appeals

- A description of the benefits provided

- The standard of review for benefit decisions

- Eligibility criteria (e.g., classes of employees, waiting period for new hires, and hours worked per week)

- The effective date of participation (e.g., next day or first of month following satisfaction of the Plan Document eligibility waiting period)

- Amount the Participant must pay towards the cost of coverage (typically $0)

- Plan Sponsor's amendment and termination rights and procedures, and what happens to Plan assets, if any, in the event of Plan termination

- Rules restricting and regulating the use of Protected Health Information (PHI), if Plan Sponsor uses PHI

- Coordination of benefits provisions

- Procedures for allocating and designating administrative duties to a Section 105 TPA or committee

- How the Section 105 plan is funded

- Information regarding COBRA, HIPAA, ACA, and other federal mandates

## Can a Business Self-Administer a Section 105 Plan?

The short answer is yes, but most experts do not recommend self-administering a Section 105 Plan without proper IRS/HIPAA/ERISA/ACA Defined Contribution Admin Software. Many employers that self-administer a Section 105 Plan often overlook important compliance obligations that put them at financial risk. Failure to comply with the following requirements is common and can be costly:

1. **COBRA** - A Section 105 plan is subject to COBRA rules
2. **HIPAA Privacy** - A Section 105 plan is governed by HIPAA Privacy rules
3. **Medicare Reporting** - A Section 105 plan is subject to Medicare Secondary Payer (MSP) provisions
4. **Legal Plan Documents** - ERISA requires that Section 105 plans be established and maintained pursuant to a written instrument
5. **ACA **- A Section 105 Plan must be designed and administered to comply with ACA and associated regulations such as PHS 2711 (prohibition on annual limits) and PHS 2713 (preventive care) -- as well as numerous new administrative requirements

[View full post](https://www.peoplekeep.com/blog/bid/324133/section-105-plan-document-requirements)

```json
{
  "@context" : "http://schema.org",
  "@type" : "BlogPosting",
  "author" : {
    "@type" : "Person",
    "name" : "Christina Merhar"
  },
  "dateModified" : "2024-11-23T00:11:18.808Z",
  "datePublished" : "2014-01-09T18:30:00Z",
  "headline" : "Section 105 Plan Document Requirements",
  "image" : {
    "@type" : "ImageObject",
    "height" : 300,
    "url" : "http://www.zanebenefits.com/hs-fs/hub/149308/file-444369178-jpg/Section_105_Plan_Document_Requirements.jpg",
    "width" : 300
  },
  "mainEntityOfPage" : "https://www.peoplekeep.com/blog/bid/324133/section-105-plan-document-requirements",
  "publisher" : {
    "@type" : "Organization",
    "logo" : {
      "@type" : "ImageObject",
      "height" : 60.0,
      "url" : "https://www.peoplekeep.com/hubfs/PeopleKeep%20Logo%20Horizontal%20RH%20Mini.png",
      "width" : 271.08435
    },
    "name" : "Personalized benefits blog: Expert insights on personalized employee benefits"
  }
}
```