As we approach the third quarter of 2026, employers sponsoring health and welfare plans, especially those governed by ERISA, must be aware of the critical compliance deadlines and ongoing reporting and disclosure obligations. While this time of year typically brings key filings such as Form 5500 for calendar-year plans, Patient-Centered Outcomes Research Institute (PCORI) fee payments, Summary Annual Report (SAR) distributions, and medical loss ratio (MLR) rebate considerations, it's crucial to stay ahead of these requirements to avoid potential penalties and maintain compliance with applicable federal laws. Coordination with service providers and internal stakeholders is essential during this period to ensure timely and accurate completion of required filings, notices, and payments. Personally, I find it particularly fascinating how these deadlines and obligations vary based on the plan type and state, requiring employers to be agile and well-informed. The PCORI tax, for instance, is a notable example. It's applicable to both insured and self-funded plans, but the plan sponsor is responsible for the tax only in the case of self-funded plans. The fee amount changes based on the plan year, and it's due by July 31, 2026, for plan years ending in 2025. What makes this particularly interesting is the exception for certain multiemployer plans, where the PCORI tax can be paid with ERISA plan assets. This detail raises a deeper question: How do these exceptions impact the overall compliance landscape, and what are the implications for plan sponsors? Form 5500 filings are another critical aspect. ERISA plans with a calendar-year plan generally must file Form 5500 by July 31 annually unless an extension is obtained. This applies to all calendar-year ERISA plans unless otherwise exempted. What many people don't realize is that welfare plans that are fully insured, unfunded, or a combination of both are excused from filing if they have fewer than 100 participants covered on the first day of the ERISA plan year. This highlights the importance of understanding the specific exemptions and requirements for different types of plans. The SAR requirement, which mandates the distribution of a summary of the plan's financial performance to participating employees, former employees, COBRA beneficiaries, and Qualified Medical Child Support Order (QMCSO) recipients within nine months of the close of the plan year, is another critical obligation. However, self-funded plans that pay benefits exclusively from the employer's general assets are exempt from this requirement, provided those contributions are made through a Section 125 cafeteria plan. This raises a deeper question: How do these exemptions impact the overall transparency and accountability of plan sponsors, and what are the implications for plan participants? The MLR rebates, which require issuers to spend a minimum percentage of their premium dollars on medical care and healthcare quality improvement, are also a significant consideration. Sponsors of insured health plans may receive rebates if their issuers do not meet their MLR. These rebates must be provided to plan sponsors by September 30, following the end of the MLR reporting year. Employers that receive rebates should consider their legal options for using the rebate, and any rebate amount that qualifies as a plan asset under ERISA must be used to benefit the plan's participants and beneficiaries. This raises a deeper question: How do these rebates impact the overall financial health of health plans, and what are the implications for plan sponsors and participants? In conclusion, as we navigate the third quarter of 2026, employers must be aware of the critical compliance deadlines and ongoing reporting and disclosure obligations. The PCORI tax, Form 5500 filings, SAR requirements, and MLR rebates are just a few of the key considerations. By staying informed and proactive, employers can ensure compliance and avoid potential penalties. However, it's crucial to remember that these obligations vary based on the plan type and state, requiring employers to be agile and well-informed. Personally, I believe that a deeper analysis of these obligations and their implications is necessary to fully understand the compliance landscape and the broader impact on health plans and their participants.
