Compliance, General

ERISA Form 5500 for Health & Welfare Plans

by GBS Benefits
April 8, 2026
9:57 am

Health Benefits Compliance

ERISA Form 5500 for Health & Welfare Plans:

A Practical Overview & FAQs

A primary reporting obligation imposed by ERISA on health and welfare benefit plans (employer sponsored group health plans) is the Form 5500 annual report requirement. Form 5500 is filed with the U.S. Department of Labor (DOL) and consists of a main body and various Schedules. The information in the Form 5500 annual report provides the regulatory agencies with a collection of data on ERISA employee health and welfare benefit plans. For example, it provides information on the number of enrolled participants, commissions of brokers, and other financial information on benefits provided.

Whether a plan must file Form 5500, and which Schedules a plan must include with its Form 5500 filing, will depend on several factors—including the plan’s size, funding method, and whether benefits are insured or self-insured.

Important Note on “Funding Method”

The discussion here of plan “funding method” categorizes plans as “funded” or “unfunded” each of which have specific definitions under ERISA. And these terms are different than, and should not be confused with, similar terms such as “self-funded” (that is commonly used to describe a self-insured plan).

Generally, “funding method” in this context refers to whether an employer sponsoring the plan is paying through a trust (“funded”) or solely through an employer’s general assets (“unfunded”).

›Because an “unfunded” plan is one in which benefits are paid solely from the general assets of the employer maintaining the plan, a plan that uses insurance to pay benefits is considered a funded plan.

›Similarly, a plan that uses “plan assets” such as employee contributions or a trust (as opposed to employer general assets) in whole or in part, to pay benefits is considered a funded plan.

However (and as an unfortunate complication), the DOL treats plans that accept participant contributions (a type of “plan asset”) under a cafeteria plan or under an insured plan as “unfunded” for purposes of the 5500 reporting obligation, provided the plan meets the conditions of DOL Technical Release 92-01. Most plans are structured to satisfy the conditions of Technical Release 92-01, and as long as the plan does not utilize a trust, the plan generally can be treated as unfunded for 5500 filing purposes.

Plans Subject to Form 5500 Reporting Requirements

ERISA covers health and welfare plans which are defined generally as any plan, fund, or program that an employer establishes or maintains to provide the following benefits:

Medical (including medical, dental, vision, and/or Rx), surgical, or hospital care
Benefits for sickness, accident, disability, or death
Unemployment benefits
Vacation benefits
Apprenticeship or other training programs
Day care centers
Scholarship funds (but only funded scholarship programs)
Prepaid legal services
Holiday and severance pay plans (or any similar benefits)
Housing assistance benefits

Unless an exception applies (e.g., the small plan exception discussed below), ERISA health and welfare plans are subject to Form 5500 reporting requirements. However, ERISA and the Form 5500 reporting requirements do not apply to:

Group health plans established or maintained by governmental entities, non-electing churches, or plans that are maintained solely to comply with applicable state workers compensation, unemployment, or disability laws.
Certain “payroll practices” (i.e., payment of certain listed benefits solely out of employer general assets) such as the payment of wages and unfunded sick pay.

HRAs and ICHRAs are subject to Form 5500 reporting requirements

HRAs and ICHRAs are subject to Form 5500 reporting requirements. Health reimbursement arrangements (HRAs) are employee welfare benefit plans and therefore are subject to ERISA and the Form 5500 filing requirement—unless an exemption applies, such as the exemption for small plans or for governmental / church plans. The same is true for ICHRAs.

Because HRAs (and ICHRAs) are self-funded plans (i.e., funded solely by the employer), no Schedules will be required for the HRA when filing Form 5500 unless the HRA utilizes a trust (see below under the “Content Requirements” section for more information).

When to File

The Form 5500 is filed with the DOL and generally is due seven months after the end of the plan year (e.g., July 31 for a calendar year plan). A two-and-a-half-month extension may be granted if requested via Form 5558 by the original deadline (e.g., October 15 would be the extended deadline for a calendar year plan that files a Form 5558 by July 31).

For a plan year of less than 12 months (i.e., a short plan year), the Form 5500 still must be filed by the regular deadline after the short plan year ends.

A “final” Form 5500 must be filed following a plan termination. The final Form 5500 is due at the regular time following the end of the final plan year (which in some situations may be a short plan year).

How Many Form 5500s are Required to be Filed by a Plan Sponsor

Plan sponsors can combine more than one type of ERISA health and welfare benefits into a single plan for Form 5500 filing purposes. To be effective, the intention to combine benefits into a single plan (under a single plan number) should be reflected in the governing plan document (e.g., in the wrap document). The Form 5500 instructions state that “[you] must review the governing documents and actual operations to determine whether welfare benefits are being provided under a single plan or separate plans.”

If a plan sponsor does not have a wrap document or fails to affirmatively determine how many ERISA plans they maintain in their governing plan document, the DOL will consider various factors to determine how many plans a sponsor maintains and therefore how many Form 5500 filings will be required. Where insured benefits are involved and there is no wrap document that bundles the benefits together into one plan, it is likely that each insurance contract will be considered a separate welfare benefit plan (requiring a separate 5500 filing for each separate plan). But if the employer offers multiple major medical benefit options, even if under separate insurance contracts, the DOL generally will consider those major medical benefit options to be a single ERISA plan because a single type of benefit (major medical) is involved.

Content Requirements

The Form 5500 annual report must include:

The type of plan and the benefits offered through the plan (e.g., medical, dental, disability).
The name and effective date of the plan, including the plan number.
The plan sponsor’s name, EIN, address, and telephone number.
The plan administrator’s name, address, and telephone number.
The total number of participants at the beginning and end of the plan year.
Whether the plan and benefits are funded by insurance, a trust, or general assets of the sponsor.
Whether the plan is subject to an M-1 filing—applicable to Multiple Employer Welfare Arrangements (MEWAs) that are required to file an M-1.
And any required Schedules.

The plan administrator should generally refer to their ERISA plan document (or wrap document) for the main content required to be in the Form 5500 (e.g., the plan sponsor name, EIN, plan name, plan number, and plan year). The DOL uses these general identifiers to track 5500s, and if the wrong information is provided year-to-year, the DOL may determine that a filing is delinquent and assess penalties.

Form 5500 main body. Any plan that must file Form 5500 must file the main body of the Form. The main body of the Form 5500 consists of three parts.

Part I (Annual Report Identification Information) requires information about the type of plan, the type of Form 5500, whether the plan operates on a calendar year, whether the plan is collectively bargained, and whether the Form 5500 is filed pursuant to an extension of time or under the Delinquent Filer Voluntary Correction (DFVC) Program.
Part II (Basic Plan Information) consists of ten numbered questions (with numerous subparts) requiring (a) identifying information about the plan, its sponsor, and its administrator; (b) information about the number of plan participants and about the type and funding of benefits; and (c) identification of the Schedules that are filed with the Form 5500.
Part III (Form M-1 Compliance Information) calls for information about whether the plan is required to file Form M-1 and (if so) whether the plan is in compliance with that requirement.

Schedules

The plan administrator must also attach Schedules to the Form 5500 when sponsoring specific types of benefits. Certain plans will file only the main body with no attached Schedules (e.g., a self-funded plan that does not utilize a trust).

Schedule A.

Schedule A is required for each fully insured contract and must include:

Information about the insurance contract, including the insurer’s name, EIN, contract number, policy year, and the number of participants covered.
The commissions and fees paid to the insurer and agents, brokers, or other individuals receiving commissions or fees from the contract.
And premium information for experience-rated and nonexperience-rated contracts.

Schedule C.

Schedule C is required for large funded plans (i.e., a plan with a trust). “Large” is defined as those with 100 or more covered participants at the beginning of the plan year. Note that plans that satisfy the conditions of DOL Technical Release 92-01 (which most plan do) will not be considered “funded” and therefore will not be required to complete and file Schedule C. So generally, a Schedule C will only be required for a plan that utilizes a trust. Schedule C must include:

The name, EIN, and address for each person who received $5,000 for more in indirect or direct compensation for services rendered to the plan or participants, the amount of compensation and the nature of services provided, and the person’s relationship to the plan, and party-in-interest information.
And upon termination, the names of accountants and enrolled actuaries.

Schedule H.

Schedule H is required for large funded plans (i.e., a plan with a trust). “Large” is defined as those with 100 or more covered participants at the beginning of the plan year. Note that plans that satisfy the conditions of DOL Technical Release 92-01 (which most plan do) will not be considered “funded” and therefore will not be required to complete and file Schedule H. So generally, a Schedule H will only be required for a plan that utilizes a trust. Schedule H must include:

The trust assets—such as cash, employer and employee contributions, investments, and real property.
The trust liabilities—such as benefit claims payable and administrative expenses.
And an accountant’s opinion.

Schedule I.

Schedule I is required for small funded plans and includes similar reporting data and an accountant’s opinion as outlined above for Schedule H. “Small” is defined as those with fewer than 100 covered participants at the beginning of the plan year. Note that plans that satisfy the conditions of DOL Technical Release 92-01 (which most plan do) will not be considered “funded” and therefore will not be required to complete and file Schedule I. So generally, a Schedule I will only be required for a plan that utilizes a trust.

How to File

Form 5500, the Schedules, and Form 5558 requests for extensions are required to be filed electronically through the EFAST2 site. Most plan sponsors utilize a third-party vendor that specializes in Form 5500 filing and that will file on their behalf.

Summary Annual Report

Fully insured and funded, self-insured plans are required to provide a summary annual report (SAR) to plan participants every year. The SAR is a summary of the Form 5500 and is due within 9 months after the end of the applicable plan year, or within two months after the due date of the Form 5500 extension deadline. If a plan sponsor uses a third-party vendor to file the 5500 on their behalf, in most cases that third-party vendor will provide the plan sponsor with the completed SAR.

Penalties

Under ERISA, significant penalties can be imposed by the DOL for any refusal or failure to file a required Form 5500. Penalties may be assessed not just for late or unfiled Form 5500s but also for incomplete or otherwise deficient Form 5500s. The penalty amounts are indexed annually for inflation. For example, the maximum penalty is $2,739 per day for penalties assessed after January 15, 2025.

The DOL takes the position that the penalties are cumulative so that the maximum per day penalty may be assessed for each Form 5500 that is not filed as required. Also, there is no statute of limitations with respect for filing failures. So, failures to correct a missed or incomplete Form 5500 may therefore leave the liability open indefinitely and the potential penalty amount growing.

The DOL is required to consider the degree and willfulness of the failure to file in determining the amount to be assessed. The penalty is computed from the date of the administrator’s failure or refusal to file the annual report and continues up to the date on which an annual report satisfactory to the DOL is filed.

If the plan administrator can show reasonable cause for its failure to file the annual report, the DOL may waive all or part of the penalty. A plan administrator must receive 30 days’ notice to file a statement of reasonable cause for the failure to file a complete annual report or to give a reason why the penalty, as calculated, should not go into effect.

As discussed below, the DOL may impose lower penalties where the plan administrator voluntarily corrects a late or missed filing under the Delinquent Filer Voluntary Compliance Program (DFVCP).

Delinquent Filer Voluntary Compliance Program (DFVCP)

The DFVCP is offered by the DOL and provides reduced civil penalties to plan administrators that failed to file Form 5500s or filed them late. Under the program, plan administrators may voluntarily correct late or unfiled Form 5500s by submitting a completed Form 5500 for the plan year(s) in question and paying the penalty amounts specified under the DFVC Program.

The penalty amount generally depends on the size of the plan and the number of days the Form 5500 is late.
In the case of a “small plan” (a plan with fewer than 100 participants at the beginning of the subject plan year), the applicable penalty amount under the DFVCP is $10 per day for each day the Form 5500 is filed after the date on which the Form 5500 was due, not to exceed the greater of $750 per Form 5500 or, in the case of a DFVCP submission relating to more than one delinquent Form 5500 for the plan (i.e., multiple years for the same plan), $1,500 per plan.
In the case of a “large plan” (a plan with 100 or more participants at the beginning of the plan year), the applicable penalty amount under the DFVCP is $10 per day for each day the Form 5500 is filed after the date on which the Form 5500 was due, not to exceed the greater of $2,000 per Form 5500 or, in the case of a DFVCP submission relating to more than one delinquent Form 5500 filing for the plan, $4,000 per plan.

Note that a plan is not eligible for relief under the DFVCP if it does not satisfy the filing and penalty-payment requirements of the program before being notified in writing by the DOL of a failure to timely file a Form 5500.

Frequently Asked Questions

1. What vendors are recommended to help with Form 5500 filings?

Wrangle and NBS are the two vendors we use most often to assist with filing the 5500. Wrangle gathers the Schedule A’s for the client and is the best vendor to use for any needed delinquent filings. NBS is a good option for standard filings.

2. What should I do if an insurance carrier fails to provide the Schedule A?

Most of the information required by Schedule A will be in the sole knowledge of the insurer, and the Form 5500 Instructions say that the insurance company is statutorily required to provide the plan administrator with the information needed to complete Schedule A. Also, the Instructions specifically direct the plan administrator to contact the insurance company if the information has not been provided and to advise them that the plan administrator will identify the insurance company on Schedule A if the required information is not provided. The plan administrator should contact the insurance company with enough advance notice to allow the insurer to respond. If necessary, the plan administrator could also contact the local DOL office to obtain assistance.

But the plan administrator should not delay filing Form 5500 if missing Schedule A information from an insurer. The Form 5500 Instructions provide that if Schedule A information is missing due to a refusal by an insurer to provide information, the filer should check “yes” on Part IV, Line 11 and specify the information was not provided on Line 12. An amended Form 5500 should then be filed when the missing information is obtained.

3. When should I collect Schedule A information from our insurers?

Plan administrators should start requesting and collecting Schedule A information early enough to allow for follow-up with insurers that do not provide required information. Insurers are generally allowed 120 days after the close of the plan year to produce the information, so beginning the request process at about 90 days after the plan year ends is typically a good time to start.

4. What if information reported on a Form 5500 changes from one plan year to the next?

If information reported on a Form 5500 changes, then this should be reported on subsequent filings. This can happen if the plan document is amended or during a merger/acquisition. For example:

If the plan sponsor name, plan name, or EIN changes—the new information should be listed in Part II (Basic Plan Information section) on page one of the Form 5500 main body. And the old information will be listed on page two under number 4.
If the plan number changes, then a final Form 5500 will be filed for the old plan number. And a Form 5500 first time filing will be made under the new plan number. For example, if the plan number for 2024 was 501 and the plan number for 2025 (and going forward) will be 502, then would file a final Form 5500 for 2024 for plan number 501. And would file a Form 5500 for 2025 for plan number 502 and mark it as a “first return/report” on page 1 of the main body. If the change in plan number took place, and the final report box was not checked, the previous 5500 should be amended accordingly.

5. What if the number of plan participants (on the first day of the plan year) drops below 100?

For the Form 5500 filing (prior to the plan year when plan participants fell below 100), on page 2 of the Form 5500 main body under number 8b, code “4R” should be listed to inform the DOL the plan is still active, but the plan has fallen below the reporting threshold due to the small plan exemption.

6. How is “funding” specified on page two of Form 5500 under 9a and 9b?

There are three choices, and the plan administrator should check all that apply:

For a fully insured plan, check the “insurance” boxes. Then a Schedule A should be included for each fully insured plan.
For a self/level-funded plan, check the “General assets of the sponsor” boxes. No Schedules will be required for a self/level-funded plan unless the plan utilizes a trust.
For a plan that utilizes a trust, check the “Trust” boxes. Then the appropriate Schedules should be included.

Exemptions for Small Plans

Some, but not all, small plans do not have a Form 5500 annual reporting obligation imposed by ERISA on health and welfare benefit plans.

Definition of Small Plan

“Small” is defined as a plan with fewer than 100 covered participants at the start of the plan year.

A covered participant includes employees and former employees (e.g., COBRA participants), but non-employees such as covered spouses and dependent children are not counted. In most cases, as long as a plan has fewer than 100 participants at the start of the plan year, they will be exempt from having to file Form 5500.

Where two or more benefit arrangements are combined into one ERISA plan for Form 5500 filing purposes (e.g., using a wrap document), the number of participants covered under the plan should be determined by counting each covered individual only once. For example, if medical benefits and life insurance benefits are bundled into a single plan, an individual covered under both the medical and life insurance components would count as one participant when determining the total number of plan participants for Form 5500 purposes and to determine if a small plan exemption applies. And remember that a “covered participant” only includes employees and former employees (e.g., COBRA participants), but non-employees such as covered spouses and dependent children are not counted.

Small Plans that Meet the Small Plan Exemption

Small unfunded, small insured, and small combination unfunded/insured plans are completely exempt from the Form 5500 filing requirement.

Small unfunded plans.

A small (fewer than 100 covered participants at the start of the plan year) unfunded plan is exempt from the Form 5500 filing requirements. As discussed above, an “unfunded” plan is one in which benefits are paid solely from the general assets of the employer maintaining the plan.

Therefore, a plan that uses insurance to pay benefits is a funded plan.
Similarly, a plan that uses plan assets such as employee contributions or a trust (as opposed to employer general assets), in whole or in part, to pay benefits is a funded plan.
However, the DOL treats plans that accept participant contributions (a type of “plan asset”) under a cafeteria plan or under an insured plan as unfunded for purposes of the 5500 reporting obligation, provided the plan meets the conditions of DOL Technical Release 92-01. Most plans satisfy the conditions of Technical Release 92-01, and as long as the plan does not utilize a trust, it can be treated as unfunded for this small employer 5500 exemption.

Small insured plans.

There is also a complete Form 5500 reporting exemption for small (fewer than 100 covered participants at the start of the plan year) insured plans. (This exemption does not apply to self/level-funded plans.) Under this exemption: (a) benefits must be paid exclusively through insurance policies; (b) premiums must be paid directly by the employer from general assets or partly from participant contributions (provided that the participant contributions are forwarded to the insurer as soon as possible but no later than three months after being withheld or contributed); and (c) insurance refunds to which contributing participants are entitled must be refunded within three months.

Small combination unfunded/insured plans.

Lastly, there is a complete Form 5500 reporting exemption for small (fewer than 100 covered participants at the start of the plan year) that are a combination unfunded (compared to funded) and insured (compared to self-insured) plans.

Note that given all these exemptions, the only type of small plans that must file Form 5500 is generally one that is self-funded (as opposed to fully insured) and pays through a trust.

Small Plans that do NOT Meet the Small Plan Exemption

The small plan exemption is NOT available for MEWAs. Note that there is no filing exemption for plans that are subject to Form M-1 filing requirements (i.e., MEWAs subject to ERISA). That is, all MEWAs that are ERISA plans (and that are required to File Form M-1) must file Form 5500, regardless of size. And Form M-1 filing compliance information must be provided as part of the Form 5500 filing. A multiple employer welfare arrangement (MEWA) is a special arrangement used to provide employee welfare benefits to the employees of two or more employers that are not part of the same control group.