Demystifying the Basics of the H&W
Q&A Session – Questions Focused on 5500s
| Question | Answer | |
| 1 | Do we file the Form 5500 when the group has 100+ at the beginning of the plan year or at the end of the plan year? | The Form 5500 is to be filed for a group when the reporting threshold of 100 or more participants are enrolled on the first day of the ERISA Plan Year. If the group is under a trust or is a MEWA that filed the Form M1, the 5500 is to be filed regardless of the number of enrolled participants.
The Form 5500 will be due seven months following the end of the Plan year. For 1/1 – 12/31 plans, the 5500 is due 7/31 of the following year. For example, 1/1/2025 – 12/31/2025 will be due 7/31/2026. |
| 2 | What is the definition of “participants?” Are dependents included? | Participants are active employees + COBRA subscribers +Retiree subscribers. Dependents are not to be included. |
| 3 | Are Casinos owned by Tribe’s to be filing a Form 5500? | Tribal casinos are to follow ERISA. This is even the case if the casino is run by the tribal government. The employees under the casino would be counted. Those serving a governmental function would not. |
| 4 | A group is participating in a MEWA Trust plan for medical, but the group administers the Dental & Vision with a separate carrier. In this scenario, does the group file a 5500 as well? | A MEWA trust plan often files the 5500 for the benefits on behalf of the Participating Employers when the MEWA is the Plan Administrator. As a result, it is to issue a SAR for the participating employers and also distribute to the Plan Participants.
The dental and vision under the Plan Sponsor would file their own 5500 if the dental and vision met the reporting threshold. We have seen MEWAs not file on behalf of the participating employer or they file but do not provide the participating employers with the SAR. Under these situations we would encourage for an ERISA attorney to review and advise. At times the participating employer has filed a 5500 in order for SARs to be available. If there is a Wrap Plan Document that combines everything together under one ERISA Plan including the medical, then the 5500 technically would include all benefits included under that Wrap. If medical is listed, under these circumstances we would suggest for the Wrap to be reviewed. It may be in error if the MEWA is the Plan Administrator. Medical may be required to be removed from the Plan Document. |
| 5 | Is a level-funded plan required to file a form 5500 even if they have fewer than 100 plan participants? | As long as the Plan is not a MEWA or a Trust, if there are less than 100 employees plus ex-employees/COBRA enrolled as of the first day of the ERISA Plan Year, the 5500 would not be required to be filed.
Level-Funded benefits are typically treated as self-insured benefits and do not need to be reported on a Schedule A. They are included in the 5500 filing by including the appropriate benefit code (4A for Medical) and checking the general assets boxes on page two of the Form 5500. |
| 6 | Some employers (HR team) are not sure of their ERISA plan date. They ask where they can go internally to double check how this was set up. They don’t have a wrap and there is conflicting information on the schedule As carriers provide vs what I see on a previously filed 5500. What is the source of truth to determine once and for all? | If there is no official written plan document in place, then the individual benefit carrier contracts would likely be the documents to review. Each separate policy would have a separate 5500. The policy period listed in the benefit documents is the ERISA Plan year. |
| 7 | Would you recommend for all plan signers to have fiduciary insurance? | Fiduciary Liability Insurance is discretionary. In general, it would be a good idea to pay for it if the employer is risk adverse and is concerned about a possible breach of fiduciary duties. More on this Insurance:
Fiduciary liability insurance protects fiduciaries against losses resulting from a breach of fiduciary duty. Because of ERISA §410(b), a plan cannot purchase or pay premiums for insurance to cover the liability of a breaching fiduciary without a recourse right. An employer may, however, purchase such insurance from its general assets (except to the extent those assets represent participant contributions, which are treated as plan assets under applicable DOL regulations). |
| 8 | Is Wrangle the Plan administrator since we use you help process our 5500 filing? | No, Wrangle is not the Plan Administrator, because we don’t administer any of the benefits for our clients. We only assist with the preparation and filing of the Form 5500 filing. Often, the Plan Administrator and Plan Sponsor are the same, the Employer. Sometimes, the Plan Administrator can be a Board of Directors or some outside entity, but it is not common. |
| 9 | If an EAP covers all employees, would the number of participants be the same as the employee count? All other benefits have eligibility requirements and would be enrolled in that benefit. | Likely, yes. If all employees receive the EAP, then the total number of participants in the EAP could be the total number of enrolled employees for the Plan. For the 5500 counts, you would not include dependents if they are allowed to enroll in the EAP. |
| 10 | Is a Wrap Plan Document optional? Or is it required if an employer has multiple benefits plans? | The requirement of ERISA is to maintain an official written plan document that describes the terms and conditions of the Plan. A Wrap document will satisfy this requirement of ERISA and will also combine the benefits under one ERISA Plan to allow for one 5500 filing annually.
Without a Wrap, each separate policy contract would be considered the Plan Document by default and could be construed to be a separate ERISA Plan and require a separate 5500 filing. Please note under a DOL audit if the auditor requests for the Plan Document. If only carrier contracts are provided, the group would not be in compliance. Side note: The term “wrap” comes from the Plan Document wrapping itself with the carrier contract(s). |
| 11 | If benefits are bundled, how do we calculate the total number of participants? For example, if 150 are enrolled in medical and an additional 15 are enrolled in dental, are we to report 165 total participants? | Each employee is only to be counted once. If those 15 employees are also enrolled in Medical, you would not count them twice. If they are not enrolled in Medical, then you would count them.
Often, the Life count is the easiest benefit to look at for the highest number of enrolled employees. |
| 12 | Why do some carriers include dependents in their enrollment count on their Schedule A? | The Schedule A is required to include dependents, if applicable to the benefit. |
| 13 | What are the qualifications that require a plan to be an ERISA plan? | Generally-speaking, if the employer offers Health & Welfare benefits to employees, they have formed an ERISA Plan. The exception is if the employer is a church or governmental as these are exempt from ERISA. |
| 14 | Why do some 5500 filings for self-funded accounts exclude Medical? Is it optional? | Self-insured benefits are not to have a Schedule A within the 5500 as they don’t have premium issued to a carrier. They instead pay an administrative service only fee to a third party administrator. As a result, the Form 5500 may not have excluded medical. The approach to include may not be known. Self-insured medical for the Form 5500 is reported by having the benefit code for health – 4A be listed under 8b on page two of the 5500 as well as having general assets checked also on page two. |
| 15 | Are self-insured with an ASO or Level Funded employer required to file? | Self-insured and level-funded benefits would need to be included in the 5500 filing if the reporting threshold was met. Also if the Plan is under a trust or if the Plan is a MEWA that reported the Form M1 with the DOL would also be required to be filed. The appropriate benefit code for the benefit and the general assets boxes would be checked on page 2 of the 5500 for self-insured benefits. |
| 16 | The employer has a Wrap Plan that includes fully insured (FI) medical and life (the benefits are bundled together). If one of those benefits reaches the threshold of 100 or more employees enrolled to trigger the 5500 filing correct? If the FI medical had 60 enrolled and the life had 70 enrolled on the first day of the plan year, the Form 5500 report would not be required. Is this correct? | You are correct for both questions. If the highest number of enrolled employees in the benefits included under the Plan as of the first day of the ERISA Plan Year is 70, and the group is not a MEWA or Trust, the Form 5500 would not be required for that plan year. |
| 17 | When is a Schedule A for stop loss to be included in the Form 5500? The employee contributions include the premium for stop loss. | The Stop Loss for a trust plan would have a Schedule A included in the Form 5500. However when there is no trust and employee contributions cover the premium, we are faced with a grey area. This is challenging to answer because the DOL has viewed stop loss as an employer benefit and does not believe it would have the Schedule A. When we have introduced to the DOL the fact that employee contributions have been used, they have asked for the ERISA attorney to review and advise. Some groups who have asked ERISA attorneys were told that when employee contributions are used, the Stop Loss Schedule A would be included. Overall, Wrangle cannot provide a definitive answer and would defer to the group’s legal to include or not as well as refer to the Wrap Plan Document.
A good source to review is an Advisory Letter from the DOL on this subject: Advisory Opinion 2015-02A |
| 18 | What do you need to do if your MEWA ended? Do you need a M1 the following year? For example, the MEWA terminated on12/2024. | If the MEWA has been filing the Form M1s, they would need to file a final Form M1 report. The Form M1 is due by March 1 in the following year. For your example you would need to file the final Form M1 report by March 1, 2025 for the 2024 Plan Year. |
| 19 | When reviewing 5500 filings on EBSA portal, it seems Schedule Cs are not commonly found included in filing when plan is self-funded or level-funded? Are they not required to be included? | The Form 5500 Instructions state to not include a Schedule C unless you have a large group under a trust and the fees paid to the service provider are $5,000 or more.
The 2024 Form 5500 Instructions, the statement is found on page 26. |
| 20 | Does a 5500 have to be done for both Employee benefits (medical,dental,vision, etc.) and your 401K plan? | Yes, both the 401k and the Health & Welfare plans have Form 5500 requirements. In fact small group 401ks often need to file since they are likely under a trust. |
| 21 | Â What is the process for a late filing? | The process of a late filing involves using the DOL’s DFVC program to pay (via online) the penalties. The best starting point is to first determine if the group was to file by reviewing the enrollment counts and then finding out the original due dates when the 5500 was to have filed. The 5500s are to be prepared, efiled and then the penalty is paid.
We have a blog on the penalty payments: https://wrangle5500.com/dol-dfvc-changes-july-2025/ To learn more please send an email to our DFVC team at dfvc@wrangle5500.com. They can send to you fact sheets on this subject and answer your questions. |
| 22 | Please go over the slide 39: The 5500 instructions page 15, section 5 Line by Line…. indicates File the 2024 Form 5500 Annual Return/Report for a plan year that began in 2024 or a DFE year that ended in 2024. Enter the beginning and ending dates in Part I. The 2024 Form 5500 Annual Return/Report must be filed electronically. | If the ERISA Plan Year is 1/1/2024 – 12/31/2024 but the BTA policy period is 3/15 – 3/14, the Schedule A for the BTA would be 3/15/2023 – 3/14/2024 because it ends within the ERISA Plan Year. If you need further assistance, please send an email to Ann McAdam at amcadam@wrangle5500.com |
| 23 | For those that use Wrangle to file 5500, could we have a training on the Wrangle portal? | The Dashboard’s homepage has a link to a prerecorded presentation as well as the links to the PowerPoint slides. For team training requests, please send an email to Ann McAdam at amcadam@wrangle5500.com. |
| 24 | Re Stop Loss question. I am not sure that I 100% agree with the interpretation. Would it be incorrect to err on the conservative side and still include? | This may be considered overreporting. However please keep in mind that what is listed in the Form 5500 is to (1) match the Wrap Plan Document and (2) will also be notated in the Summary Annual Report (SAR). The participants may wonder what is the Stop Loss Benefit. |