Plan Administrator

The plan administrator is the person or entity legally responsible for running an ERISA health plan: filing the Form 5500, giving members the Summary Plan Description, answering document requests, and making sure claims are decided under the plan's terms. Unless the plan document names someone else, the plan administrator is the employer itself.

People confuse the plan administrator with the third-party administrator, and the difference matters when things go wrong. The TPA is a hired vendor that processes claims; the plan administrator is the fiduciary who answers for the plan. If a member requests plan documents and doesn't get them within 30 days, the penalty of up to $110 a day is assessed against the plan administrator, not the TPA. In practice the role sits with HR or the benefits committee, and in a small company it's often the owner without anyone having said so out loud. The plan document should name the administrator explicitly; if it names the company, the company should know which person is carrying the duty.

The takeaway: find out who your plan document names as administrator. If it's your company, write down who inside the company owns the job, because the deadlines and penalties attach to someone either way.