Form 5500 for health and welfare plans: who files and when

Form 5500 is the annual report that ERISA requires employee benefit plans to file with the Department of Labor, filed electronically through EFAST2. For health and welfare plans (medical, dental, vision, life, disability, EAP, FSA), the rule most employers need is simple: a plan with 100 or more participants at the start of the plan year generally files; a plan with fewer than 100 that is fully insured, unfunded, or a combination of the two generally does not. The traps are the participant count, the funding method and the due date.

Who has to file

The filing requirement belongs to the plan administrator, which is the employer unless the plan document names someone else. The DOL's Form 5500 instructions give these rules for welfare benefit plans:

• 100 or more participants at the beginning of the plan year: file Form 5500 with the applicable schedules, regardless of funding method.
• Fewer than 100 participants, and the plan is unfunded, fully insured, or a combination of the two: exempt from filing. An unfunded plan pays benefits from the employer's general assets. A fully insured plan pays benefits through insurance contracts. A combination is partly one and partly the other.
• Fewer than 100 participants, funded through a trust (such as a VEBA): must file, using Form 5500-SF if eligible.
• Cafeteria plan contributions: employee contributions to a health FSA or premium-only plan that are held in the employer's general assets are generally treated as unfunded for this purpose, according to DOL guidance, so a small cafeteria plan typically does not file. If the employer puts the money in a trust, the plan loses that treatment.

These rules come from the instructions for the Form 5500 series; there is no minimum employer size in ERISA itself, only the participant count for filing.

Counting participants

For a welfare plan, participants include active employees who are covered and retirees, COBRA beneficiaries and others with a right to benefits, but not employees who are eligible and decline coverage. Count at the beginning of the plan year, not the end. Covered dependents are not counted separately. For an insured or unfunded plan sitting at 98 participants on January 1 and 112 on December 1, the plan is still a small plan for the year.

The 80-120 participant rule

An administrator may use the prior-year filing status if the count is between 80 and 120. A plan that filed as small (under 100) last year and reports between 80 and 120 participants this year may keep filing as a small plan. A plan that filed as large and now has between 80 and 120 may keep filing as a large plan. The rule softens the cliff at 100, which is useful for companies near the threshold.

What goes in the return

Most welfare plans file Form 5500 with schedules, not the shorter Form 5500-SF, which is limited to small plans (generally fewer than 100 participants) with certain simple funding arrangements.

• Schedule A (insurance information) lists each insurance contract, premiums, commissions and fees. It is the schedule your broker's compensation appears on.
• Schedule C (service provider information) reports compensation of $5,000 or more to service providers and the information about those providers.
• Schedule H or I (financial information) is for plans that hold assets in a trust; Schedule H is for large plans and Schedule I for small. Insured plans with no trust skip it.
• Audit. A large plan that has a trust, or that is self-funded with assets, generally needs an independent qualified public accountant's report. Fully insured and unfunded large welfare plans are generally exempt from the audit and from some schedules.
• Summary annual report (SAR). Participants must receive a summary of the filed return within nine months after the plan year ends, or two months after the extended due date.

Insured plans from the same carrier sometimes file one Form 5500 for a wrap plan that combines health, dental, vision, life and disability under one plan number. Plan numbers for welfare plans begin with 501. Whether to file separately or together is a plan design question for the administrator and counsel.

Deadlines

The return is due on the last day of the seventh month after the plan year ends: July 31 for a calendar-year plan. Form 5558 extends the deadline by 2.5 months, to October 15 for a calendar-year plan. For the 2025 plan year, that extended date is October 15, 2026. Filing is electronic through EFAST2-approved software or the DOL's IFILE system; the DOL notes that Form 5500-SF and the schedules must be filed electronically (DOL Form 5500 page). The filing is free; vendors and TPAs charge for preparing it.

The return uses the plan administrator's electronic signature credentials. If your broker or TPA files on your behalf, you still own the content and the signature, so review what they submit.

Penalties and the correction program

The DOL can assess a civil penalty for late or missing Form 5500 filings. For 2026, penalty amounts were left at their 2025 levels, and Mercer's summary of the DOL table lists the Form 5500 failure-to-file penalty at $2,739 per day (Mercer). The penalty accrues from the due date until the return is filed.

The Delinquent Filer Voluntary Compliance Program (DFVCP) lets an administrator file overdue returns at a reduced penalty if the DOL has not already notified them of the failure. According to the DOL's DFVCP page, the basic penalty is $10 per day, with a cap of $750 per filing and $1,500 per plan for small plans, and $2,000 per filing and $4,000 per plan for large plans. Small plans of 501(c)(3) sponsors have a $750 per-plan cap. Top hat plans, apprenticeship and training plans, and late Form M-1 filings pay a flat $750. Amended filings and one-participant plans are not eligible. The program is a strong reason to fix a missed filing before a letter from the DOL arrives.

Worked examples (hypothetical)

1. A 65-employee firm, fully insured medical, dental and life. With about 58 covered participants on January 1, the plan has fewer than 100 participants and is fully insured, so no Form 5500. The employer still needs a plan document and SPD.
2. A 140-employee distributor with a self-funded medical plan and stop-loss coverage. With 125 participants at the start of the year and a trust or segregated account, the plan files a full Form 5500 with Schedule A (the stop-loss contract), Schedule C and Schedule H, plus an audit. If it pays claims from general assets with no trust, it may be unfunded and exempt from the audit. See level-funded health plans: how they work, who they suit and the catches for how that funding variant is built, and ask counsel how it is reported.
3. A 95-employee company that was at 130 participants last year. Participants fall between 80 and 120, so the company may continue to file as a large plan for the year.

Form 5500 and ACA reporting are different filings

Employers sometimes confuse Form 5500 (DOL, plan-level, annual) with Forms 1094-C and 1095-C (IRS, employer-level, for applicable large employers). They have different deadlines, thresholds and penalties. See ACA reporting: Forms 1094-C and 1095-C for large employers. A self-funded health plan with stop-loss may need both.

Checklist

1. List every welfare plan and its plan year.
2. Count participants on the first day of each plan year; keep the headcount record.
3. Decide funded or unfunded, and whether the plan is fully insured, partly self-funded or fully self-funded (fully insured vs self-funded health plans: which fits your business).
4. Calendar July 31 and the Form 5558 extension date; request the Schedule A data from carriers early.
5. Confirm who holds the EFAST2 credentials and who signs.
6. Send the SAR to participants on time.
7. If you missed a filing, check DFVCP before the DOL contacts you.

Key takeaways

• Welfare plans with 100 or more participants at the start of the plan year generally file Form 5500; fully insured or unfunded plans under 100 generally do not.
• Count participants on the first day of the plan year, and use the 80-120 rule if you are near the line.
• The return is due July 31 for a calendar-year plan, extendable by Form 5558 to October 15 (October 15, 2026 for the 2025 plan year).
• DOL penalties for a late filing run up to $2,739 per day in 2026, but DFVCP caps small-plan costs at $1,500 per plan if you come forward first.
• Form 5500 is a plan-level DOL filing; it is separate from the IRS ACA forms.