Form 5500s for Health & Welfare Plans

As we approach the deadline for calendar year ERISA plans to file their annual 5500 Forms, we thought it would be a good idea to dive a little deeper into some of the trickier aspects of timely preparing and filing the annual reports. The Form 5500 Series is part of ERISA’s reporting and disclosure framework and serves as a key compliance tool for the Department of Labor (DOL). For health and welfare plans, the Form 5500 is an annual filing that provides information about an employer’s ERISA benefit plans, including medical, dental, vision, life and more.

These filings are publicly available and are used to monitor compliance, evaluate benefit trends, and ensure transparency for plan participants. While retirement plans are also subject to Form 5500 requirements, this summary focuses on health and welfare plans.

Which Plans Must File

Form 5500 filing requirements apply to benefit plans that are subject to ERISA. Most employer-sponsored health and welfare benefits fall into this category.

In general, an unfunded ERISA plan, where claims and plan expenses are paid out of the employer’s general assets, must file a Form 5500 if there are 100 or more participants at the beginning of the plan year. Participant counts include covered employees and certain former employees (such as COBRA participants), but do not include spouses or dependents.

Plans that are funded (funds segregated in a separate account or trust – e.g., a VEBA) must file regardless of size. In addition, plans sponsored through a multiple employer welfare arrangement (MEWA) are subject to filing requirements even if participant counts are below 100.

Certain arrangements are not subject to ERISA and therefore do not require a Form 5500. These include plans sponsored by government or church employers, certain voluntary benefits with minimal employer involvement, and common payroll practices such as PTO or sick leave paid from the employer’s general assets.

Filing Deadlines and Process

Form 5500 filings are due on the last day of the seventh month following the end of the plan year, including short plan years. For calendar year plans, this typically means a July 31 deadline. Employers may request an automatic extension of up to 2½ months by filing Form 5558, extending the deadline to October 15 for calendar year plans.

All filings must be submitted electronically through the DOL’s EFAST2 system. Employers may prepare filings directly using the DOL’s online tools or work with third-party vendors such as consultants, accountants, or legal advisors. Individual filing credentials are obtained through Login.gov and are tied to individuals rather than specific companies.

Determining the Number of Filings

A separate Form 5500 is required for each ERISA plan. However, employers have flexibility in defining what constitutes a single plan through plan documentation. Many employers use a WRAP document to bundle multiple benefits, such as medical, dental, vision, and life insurance, into one ERISA plan.

Bundling benefits can significantly simplify reporting by allowing a single Form 5500 filing, provided the combined plan meets the filing threshold. Without a WRAP document, each benefit may be treated as a separate plan, potentially requiring multiple filings.

For employers operating within a controlled group, a single Form 5500 may be filed for a shared plan, with one entity designated as the plan sponsor. In contrast, multiple employer welfare arrangements (MEWA) may require separate filings depending on how the plan is structured and governed.

Form Structure and Required Information

The Form 5500 consists of a main body and, where applicable, supporting schedules. The main body includes three parts:

1. Plan year, plan type, and filing type (e.g., first, final, amended);

2. Plan identifiers (e.g., plan name, number, and effective date), plan sponsor and plan administrator’s name, EIN and contact information, participant counts at start and end of plan year, codes to indicate what types of benefit are offered, plan funding details, and which schedules, if any, are attached; and

3. Indication of whether the plan is a MEWA required to file a Form M-1.

Additional schedules may be required depending on how the plan is funded and administered. Fully- insured plans require Schedule A, which includes insurance-related information provided by carriers. If the insurance company does not automatically furnish a Schedule A, it is the employer’s responsibility to request one. Should the carrier fail to provide a Schedule A, the employer must still complete the Schedule A to the best of their ability and indicate that the carrier failed to provide the required information.

With unfunded, self-funded plans, often only the Form 5500 main body is required, and no schedule attachments are necessary.

When multiple benefits are combined under a WRAP document, the filing must reflect the entire plan, including total participant counts and all applicable benefit types and funding sources.

Penalties and Correction Programs

Failure to file a required Form 5500 can result in significant penalties. Under ERISA, penalties can accrue daily and reach substantial amounts if left unaddressed. A filing that is rejected is treated as not filed until corrected.

To encourage compliance, the DOL offers the Delinquent Filer Voluntary Compliance Program (DFVCP), which allows employers to submit late filings with significantly reduced penalties. This program is generally available only if the employer takes action before being contacted by regulators.

Summary Annual Report (SAR)

Employers that file a Form 5500 may also be required to distribute a Summary Annual Report (SAR) to plan participants. The SAR is a simplified summary of the Form 5500 and includes basic financial and plan information, along with participant rights. In practice, SAR requirements most commonly apply to fully-insured plans (most self-funded plans are exempt). The SAR must generally be distributed within nine months after the end of the plan year, or within two months after an extended filing deadline. Distribution must comply with ERISA disclosure rules, which allow delivery by mail, hand, or electronically under certain conditions.

Key Takeaways

Form 5500 compliance is an important component of ERISA plan administration and requires careful attention to plan structure, participant counts, and funding arrangements. Employers should regularly review their benefit structure, confirm whether filing thresholds are met, and ensure that filings are completed accurately and on time.