Open enrollment: next year's plan documents are out now
Share your plan documents
What is health insurance through work going to cost next year? Help us find out by sharing the documents your plan gives everyone.
What the numbers can't show yet
Why we're asking
None of Denial Watch's denial rates cover plans through work
Plan documents won't show denial rates, but they show the rules behind denials.Once enough people share, we'll publish what we learn, combined across plans, never your documents themselves.
More about why we're asking
We started with public records. Denial Watch shows how often marketplace plans deny claims and how often plans deny requests for approval. Where people get coverage shows that nearly half of people have coverage only through a job, and Denial Watch has no denial rates for those plans. Plan documents won't show how often a plan denies care either, but they show the rules behind its denials: what needs approval first and what's left out.
With plan documents we can show what plans cost for one person and for a family, what common care costs, how deductibles and out-of-pocket limits change each year, what plans leave out, and what needs approval first.
What we publish describes the plans people share with us: what people are offered, not which plans they chose or every plan in the country. Each finding says how many plans it comes from.
Once a year we ask everyone to request their plan documents and share them with us. You can share anytime.
No documents yet?
How to get your full plan documents
You can ask your plan for its full documents, not just a summary.
Plans through a private employer
Most job-based plans at private companies follow a federal law called ERISA. Plans from government employers and most churches don't.
- You can ask in writing for the plan's key documents: the Summary Plan Description, the full plan document, the insurance policy if the plan is insured, the latest annual report (Form 5500), and any changes made since the Summary Plan Description.
- A covered spouse or child can ask too, and some former employees can as well.
- Send your request to the plan administrator. Their name and address are in your Summary Plan Description. It may be your employer rather than the insurance company on your card. No Summary Plan Description? Search for your plan's Form 5500 on the Department of Labor's free Form 5500 search. It names the administrator.
- They have 30 days to mail the documents. If they don't, a judge can order them to pay you up to $110 a day. You would have to go to court to get it.
- They can charge for paper copies, but no more than 25 cents a page, and no postage or handling fees. You can ask what it will cost first.
- Small plans may not file an annual report, so there may be none to send.
- If they don't answer, the Department of Labor's Employee Benefits Security Administration can help: askebsa.dol.gov or 1-866-444-3272.
Send your letter by certified mail with a return receipt, so you can show when they got it, and keep a copy.
A letter you can send
Want a reminder?
We'll email you once, 30 days from now, so you can upload what you get. It's the only email we'll send, and we delete your address when we send it.
Getting documents for other kinds of plans
- Job-based and individual plans: you can ask for a Summary of Benefits and Coverage at any time, and the plan or insurer must send it within 7 business days. It is only a summary. One from an insurer must list a web address for the full policy. For a job-based plan, that address is for the certificate of coverage, which is not the full group policy.
- Marketplace plans on HealthCare.gov: the Summary of Benefits and Coverage is linked from each plan's page on HealthCare.gov when you preview plans. The full policy is at the web address in it. If your state runs its own marketplace, or you bought your plan straight from an insurer, ask the insurer for it.
- Government and most church employer plans: ERISA doesn't cover these, so ask the benefits office for the plan's governing document. State and local government plans must still give you a Summary of Benefits and Coverage.
- Federal employees: your plan's brochure on OPM's site is the official statement of benefits.
- Medicare Advantage: your plan sends an Annual Notice of Change by September 30, and its Evidence of Coverage, or a notice of how to get it, by October 15. The plan posts it online and must mail you a paper copy if you ask.
- Medicaid managed care: your plan must give you a member handbook. If it's online, the plan must mail you a free paper copy within 5 business days of asking.
After a denial
Ask for your claim file. Job-based plans covered by ERISA, and individual and Marketplace plans that aren't grandfathered, must give you free copies of the documents about your claim. That includes any internal rule or guideline they used to deny it.
Sources
- ERISA section 104(b)(4), 29 U.S.C. 1024: the right to plan documents
- 29 U.S.C. 1002: who counts as a participant, beneficiary and plan administrator
- 29 U.S.C. 1003: plans ERISA doesn't cover
- 29 U.S.C. 1132(c)(1) and 29 CFR 2575.502c-1: the 30 days and the $110 a day
- 29 CFR 2520.102-3: what a Summary Plan Description must say
- 29 CFR 2520.104b-30: charges for copies
- 29 CFR 2520.104b-1: documents are mailed to the address you give
- 29 CFR 2520.104-20: small plans that file no annual report
- Department of Labor, Reporting and Disclosure Guide
- Department of Labor, Understanding Your Fiduciary Responsibilities Under a Group Health Plan
- Department of Labor, Filing a Claim for Your Health Benefits
- Department of Labor, Form 5500 search
- 29 CFR 2560.503-1 and 45 CFR 147.136: your claim file after a denial
- 29 CFR 2590.715-2715 and 45 CFR 147.200: the Summary of Benefits and Coverage
- HealthCare.gov, Summary of Benefits and Coverage
- OPM, federal employee plan information
- Medicare, Understanding Medicare Advantage Plans and 42 CFR 422.111
- 42 CFR 438.10: Medicaid managed care member handbooks
Checked October 23, 2026. This is general information, not legal advice.