Last Updated on March 30, 2026 by admin
Employers who sponsor health insurance plans with 100 or more participants at the start of the plan year must file Form 5500 with the Department of Labor (DOL). This annual return reports financial and operational details about the plan to the federal government.
If your company offers a group health plan, dental plan, vision plan, or any other ERISA covered welfare benefit plan, Form 5500 filing requirements likely apply to you. The form helps the DOL, IRS, and Pension Benefit Guaranty Corporation (PBGC) monitor plan compliance and protect the interests of plan participants.
Small plans with fewer than 100 participants may qualify for an exemption from Form 5500, but only if the plan meets specific conditions. Unfunded or fully insured small welfare plans (including health insurance) that cover fewer than 100 participants generally do not need to file. However, many employers file voluntarily or are required to file because their plan structure does not meet the exemption criteria.
Here is a quick summary of who files and who does not:
- Must file: Employers with ERISA covered health plans that have 100+ participants
- Usually exempt: Fully insured or unfunded welfare plans with fewer than 100 participants
- Must file regardless of size: Self funded health plans, plans that hold trust assets, and plans that use a VEBA (Voluntary Employees’ Beneficiary Association) trust
- Never required to file: Government plans, church plans, and plans that cover only the business owner and spouse
Understanding your filing obligations prevents costly penalties and keeps your health plan compliant with federal law.
Disclaimer: Form 5500 filing rules involve complex ERISA regulations that depend on your plan type, size, and funding arrangement. This guide provides general information. Always consult an ERISA attorney, benefits consultant, or CPA for advice specific to your plan.
What Is Form 5500?
Form 5500 is an annual information return that plan administrators file with the DOL. Congress created this requirement under the Employee Retirement Income Security Act (ERISA) of 1974 to promote transparency and accountability in employee benefit plans.
The form collects information about:
- The number of participants in the plan
- The plan’s financial condition and operations
- The type of benefits the plan provides
- The plan’s funding arrangement (fully insured, self funded, or level funded)
- Service providers and their compensation
- Compliance with ERISA requirements
The DOL uses Form 5500 data to enforce ERISA rules, identify plans that may have compliance issues, and provide public access to plan information. Anyone can search Form 5500 filings through the DOL’s EFAST2 system.
Which Version Do You File?
The DOL offers three versions of the form:
Form Version | Who Files It | Plan Size |
Form 5500 | Large plan administrators | 100+ participants at the start of the plan year |
Form 5500 SF (Short Form) | Small plan administrators | Fewer than 100 participants (when filing is required) |
Form 5500 EZ | Solo business owners | Plans covering only the owner (and spouse), no employees |
For health insurance plans, most filers use either Form 5500 or Form 5500 SF. Form 5500 EZ applies primarily to solo retirement plans, not health plans.
Who Must File Form 5500 for Health Insurance Plans?
The filing requirement depends on three factors: plan size, funding type, and ERISA coverage. Let’s break each one down.
Large Health Plans (100+ Participants)
Every ERISA covered health plan with 100 or more participants at the start of the plan year must file Form 5500. This applies regardless of whether the plan is:
- Fully insured (purchased from an insurance carrier)
- Self funded (employer pays claims directly)
- Level funded (fixed monthly payments with stop loss insurance)
The 100 participant count includes all covered employees and COBRA participants. It does not count dependents (spouses and children). If you cover 85 employees and 15 COBRA beneficiaries, your plan has 100 participants and must file.
Small Health Plans (Fewer Than 100 Participants)
Small welfare benefit plans, including health insurance, enjoy a conditional exemption from Form 5500. Your small plan qualifies for the exemption if it meets ALL of these conditions:
- The plan covers fewer than 100 participants at the start of the plan year
- The plan pays benefits entirely from the employer’s general assets, entirely through insurance contracts, or a combination of both
- The plan does not hold assets in a trust (other than insurance contracts)
- The insurance carrier or HMO is responsible for paying claims and processing benefits
If your small health plan meets these criteria, you do not need to file Form 5500. Most small employers with fully insured group health plans fall into this category.
When Small Plans Must Still File
Some small health plans must file even though they have fewer than 100 participants:
- Self funded plans that hold trust assets. If your plan uses a trust, VEBA, or 501(c)(9) account to hold plan funds, you must file regardless of size.
- Plans with participant contributions held in trust. If employees contribute to the plan and those contributions pass through a trust, filing applies.
- Plans that do not meet all exemption conditions. If even one condition for the small plan exemption fails, you must file Form 5500 SF.
Plans That Never File Form 5500
Certain health plans fall completely outside the Form 5500 requirement:
- Government employer plans (federal, state, county, city, and school district plans)
- Church plans that have not elected ERISA coverage
- Plans covering only the business owner (and their spouse) with no common law employees
- Health Reimbursement Arrangements (HRAs) and Health FSAs that meet certain conditions may also qualify for exemptions
How Do You Count Participants for Form 5500?
Getting the participant count right matters because it determines whether you file, which form you use, and whether you need an audit.
The 80 to 120 Participant Rule
The DOL uses a special rule for plans near the 100 participant threshold. If your plan had between 80 and 120 participants at the start of the current plan year, you can file the same form you filed the previous year.
For example, if your plan had 95 participants last year (small plan, no filing required) and grows to 110 this year, the 80 to 120 rule lets you continue treating the plan as a small plan for one more year. This prevents employers from switching back and forth between large and small plan filing requirements each year.
Who Counts as a Participant?
A participant is any employee or former employee who:
- Currently receives benefits under the plan (active enrolled employees)
- Continues coverage under COBRA
- Has a pending claim for benefits
- May become eligible for benefits under the plan terms
Dependents (spouses and children covered under an employee’s enrollment) do not count as separate participants.
Counting Example
Your company covers 78 active employees, 8 COBRA participants, and 4 former employees with pending claims. Dependents covered under the plan total 120.
- Participant count: 78 + 8 + 4 = 90
- Dependents do not count
- Your plan has 90 participants (small plan)
When Is Form 5500 Due?
Form 5500 must reach the DOL by the last day of the seventh month after your plan year ends.
Plan Year End | Filing Deadline | Extended Deadline (With Form 5558) |
December 31 | July 31 | October 15 |
June 30 | January 31 | April 15 |
March 31 | October 31 | January 15 |
How to Get an Extension
File Form 5558 with the IRS before your original deadline to receive an automatic 2.5 month extension. For calendar year plans, this moves the deadline from July 31 to October 15.
If your business also files a federal tax return extension (Form 7004), the plan may automatically receive a Form 5500 extension as well. Check with your CPA or ERISA advisor to confirm.
How Do You File Form 5500?
All Form 5500 filings must go through the DOL’s EFAST2 electronic filing system. Paper filings are not accepted.
Step by Step Filing Process
- Gather your plan information. Collect the plan document, insurance contracts, trust financial statements, participant counts, and service provider fee disclosures.
- Determine your form version. Use Form 5500 for large plans (100+ participants) or Form 5500 SF for small plans that must file.
- Complete the applicable schedules. Large health plans typically attach Schedule A (insurance information) and Schedule C (service provider information). Self funded plans may also need Schedule H (financial information) or Schedule I (small plan financial information).
- Obtain an audit if required. Large plans with 100+ participants generally need an independent qualified public accountant (IQPA) audit report attached to the filing. Some exceptions exist for fully insured plans.
- File electronically through EFAST2. You can file directly at efast.dol.gov or use approved third party filing software.
- Distribute a Summary Annual Report (SAR). After filing, you must provide a SAR to plan participants within nine months of the plan year end (or two months after the extended filing deadline).
What Are the Penalties for Not Filing Form 5500?
The DOL and IRS take Form 5500 compliance seriously. Penalties for late or missing filings are steep.
Penalty Source | Amount | Details |
DOL civil penalty | Up to $250 per day | No maximum cap, can accrue indefinitely |
IRS penalty | $250 per day, up to $150,000 per plan year | Applies to each return that is late or incomplete |
DOL Delinquent Filer Voluntary Compliance Program (DFVCP) | $10 per day, capped at $750 (small plan) or $2,000 (large plan) per filing | Reduced penalties for voluntary late filers |
How to Fix a Late Filing
The DOL’s Delinquent Filer Voluntary Compliance Program (DFVCP) offers significantly reduced penalties for employers who voluntarily submit late Form 5500 filings. Rather than facing $250 per day from the DOL, you pay a flat reduced amount:
- Small plans: $10 per day, capped at $750 per late filing
- Large plans: $10 per day, capped at $2,000 per late filing
- Maximum penalty per employer: $4,000 for multiple late filings submitted at the same time
If the DOL contacts you about a missing filing before you voluntarily correct it, DFVCP rates no longer apply, and full penalties kick in. Filing proactively saves significant money.
Real Life Scenarios: Who Files and Who Does Not
Scenario 1: Small Business With Fully Insured Health Plan
A marketing agency in Denver employs 45 people. They offer a fully insured group health plan through Aetna. The employer pays premiums directly to Aetna. No trust holds plan assets.
- Participants: 45 (under 100)
- Funding: Fully insured
- Trust assets: None
- Filing requirement: Exempt from Form 5500
Scenario 2: Growing Company Crosses the 100 Participant Threshold
A tech company in Austin covers 105 employees and 7 COBRA participants under a self funded health plan. Total participants: 112.
- Participants: 112 (over 100)
- Funding: Self funded with a third party administrator
- Trust assets: Yes (claims fund held in trust)
- Filing requirement: Must file Form 5500 with Schedule H and IQPA audit report
Scenario 3: Small Self Funded Plan With a VEBA Trust
A law firm in Chicago has 30 attorneys and staff. They operate a self funded health plan that uses a VEBA trust to hold claims reserves.
- Participants: 30 (under 100)
- Funding: Self funded
- Trust assets: Yes (VEBA)
- Filing requirement: Must file Form 5500 SF despite small size because of the trust
Scenario 4: Church Health Plan
A church employs 60 people and offers a group health plan. The church has not elected ERISA coverage.
- Plan type: Church plan
- ERISA status: Exempt
- Filing requirement: No Form 5500 required
Frequently Asked Questions
Most small employers with fewer than 100 participants who offer fully insured health plans do not need to file Form 5500. The small plan exemption applies when the plan pays benefits through insurance contracts or the employer’s general assets, and no trust holds plan funds. However, small self funded plans with trust assets must file regardless of size.
The DOL can assess penalties of up to $250 per day with no maximum cap for each day a Form 5500 filing is late. The IRS can add $250 per day up to $150,000 per plan year. To avoid these amounts, use the DOL’s Delinquent Filer Voluntary Compliance Program, which caps penalties at $750 for small plans and $2,000 for large plans per late filing.
A fully insured health plan with 100 or more participants must file Form 5500 annually. Fully insured plans with fewer than 100 participants generally qualify for the small plan exemption and do not need to file. The key factor is participant count, not the funding method.
For plans with a December 31 plan year end, Form 5500 is due by July 31 of the following year. You can extend the deadline to October 15 by filing Form 5558 before July 31. If your business already filed a federal tax extension, your plan may automatically receive the Form 5500 extension as well.
Health Reimbursement Arrangements (HRAs) and health FSAs may qualify for Form 5500 exemptions under certain conditions. If the HRA or FSA is part of a larger group health plan that already files Form 5500, the HRA or FSA benefits get reported on that filing. Standalone HRAs with fewer than 100 participants and no trust assets generally qualify for the small plan exemption.
The plan administrator identified in the plan document holds responsibility for filing Form 5500. In most cases, this is the employer or a committee designated by the employer. If the plan document does not name a specific administrator, the employer itself serves as the default plan administrator under ERISA. The plan administrator can hire a third party (like a benefits consultant or TPA) to prepare and submit the filing, but the legal responsibility remains with the plan administrator.
Key Takeaways for Employers
Form 5500 filing depends primarily on your plan size, funding method, and whether your plan holds trust assets. Most small employers with fully insured health plans qualify for the exemption. Large plans with 100 or more participants must always file. Self funded plans with trusts must file regardless of size. Missing a deadline triggers severe penalties, but the DFVCP program offers a low cost path to fix late filings.
Review your plan structure each year to confirm whether you must file. Work with a benefits consultant, ERISA attorney, or CPA who understands the current rules.
If you need help comparing health insurance plans for your business or family, Alias Insurance provides free quotes from top providers across the United States. Finding the right coverage starts with understanding your options and your compliance obligations.
