ERISA compliance
ERISA compliance for employer health plans, in plain English.
Plan Documents, SPDs, Form 5500, fiduciary documentation, required participant notices. The 2026 Form 5500 deadline is July 31 for calendar-year plans.
The short version
The Employee Retirement Income Security Act of 1974 (ERISA) sets minimum standards for most private-sector employee benefit plans, including health insurance. Most employer-sponsored group health plans must comply with ERISA, with limited exceptions for governmental and church plans. Core ERISA requirements include a written Plan Document, a Summary Plan Description (SPD) given to all participants, fiduciary conduct standards, and — for plans with 100+ participants — annual Form 5500 filings due July 31 for calendar-year plans.
The four ERISA pillars
What every ERISA-governed plan must have.
Plan Document
The legal blueprint of the plan. Named fiduciary, amendment procedures, claims procedures, eligibility, funding source.
Summary Plan Description
Plain-language explanation distributed to participants. Required within 90 days of becoming covered; updated every 5 years.
Fiduciary conduct
Plan administrators must act in participants' interests and follow prudent processes.
Reporting & disclosure
Form 5500, Summary Annual Report (SAR), event-driven notices to participants.
Form 5500 — who has to file
The 100-participant threshold is the trigger.
✓ Counted as participants
- ·Covered employees
- ·Covered former employees who are COBRA qualified beneficiaries
- ·Covered retirees
✕ NOT counted
- ·Covered dependents (spouses, children)
2026 Form 5500 deadline
July 31, 2026 for calendar-year plans. Penalties are real.
- ·Plan year January 1 – December 31, 2025 → Form 5500 due July 31, 2026
- ·Extension via Form 5558 extends the deadline 2.5 months to October 15
- ·Late filing penalties run up to roughly $2,739/day in 2026 (subject to annual inflation adjustment)
Plan Document essentials
Eight elements an ERISA Plan Document must address.
- ·Named fiduciary
- ·Plan amendment procedure
- ·Funding policy
- ·Allocation of responsibilities
- ·Claims procedure
- ·Eligibility and benefits
- ·Funding source
- ·Plan year
SPD essentials
What participants must be told.
- ·Plan name, sponsor, EIN, plan number
- ·Type of plan (welfare, pension)
- ·Type of administration
- ·Fiduciaries identified
- ·Eligibility requirements
- ·Description of benefits
- ·Claims procedures with specific timelines
- ·Statement of ERISA rights
- ·Loss of benefits circumstances
SPDs must be distributed to participants within 90 days of becoming covered, and updated every 5 years (10 years if no plan changes).
What TMRW handles
Six compliance lines we manage for employer clients.
ERISA Plan Documents
Drafting Plan Documents or wrap documents combining carrier certs with required ERISA elements.
SPD drafting + annual review
SPD creation and ongoing maintenance; participant distribution coordination.
Form 5500 prep + filing
Annual Form 5500 preparation and filing for plans with 100+ participants. Schedule A and Schedule C as needed.
Section 125 documents
Cafeteria plan documents to allow pre-tax employee premium contributions.
Required notice tracking
Initial COBRA, SBC, Medicare Part D Creditable Coverage, CHIP, WHCRA, etc.
ACA reporting
Forms 1094-C and 1095-C for ALEs (50+ FTEs).
FAQ
Frequently asked questions
Does my company need ERISA documents?
Most employer-sponsored health plans must comply with ERISA. Government and church plans are typically exempt; everyone else needs a written Plan Document, an SPD, and proper participant notices. Even fully-insured small employers — carrier certificates of coverage alone are NOT a Plan Document.
When do I have to file Form 5500?
You must file Form 5500 if your ERISA-governed health plan had 100 or more participants on the first day of the plan year. Participants count includes covered employees, COBRA-qualified beneficiaries, and covered retirees — but NOT covered dependents. Small plans (under 100 participants) that are unfunded or fully insured are typically exempt.
What's the 2026 Form 5500 deadline?
For plan year January 1 – December 31, 2025, Form 5500 is due July 31, 2026. Extension via Form 5558 extends the deadline 2.5 months to October 15. Late filings face significant DOL penalties — up to roughly $2,739/day in 2026 (subject to annual inflation adjustment).
What's the difference between a Plan Document and an SPD?
The Plan Document is the formal legal document establishing the plan — named fiduciary, amendment procedures, claims procedures, eligibility, funding source. The SPD (Summary Plan Description) is the plain-language version distributed to participants explaining how the plan works. Both are required; the Plan Document is the legal authority, the SPD is the participant-facing summary.
What is a wrap document?
A wrap document combines carrier-issued certificates of coverage with the additional ERISA-required elements (named fiduciary, amendment procedures, claims procedures, etc.) to satisfy ERISA Plan Document requirements. Most fully-insured small and mid-sized employers need a wrap document because carrier certificates alone don't cover all ERISA Plan Document requirements.
What are my fiduciary duties as a plan sponsor?
ERISA fiduciaries must act solely in participants' interests (duty of loyalty), follow prudent processes when making plan decisions, and follow plan documents. The named fiduciary is typically the plan sponsor (the employer) by default. Many employers delegate functions to a TPA or benefits committee, but liability stays with the named fiduciary unless properly transferred.
Identify the gaps
Free 30-minute compliance review.
We review your current plan documents, SPD, Form 5500 history, and required notices. Show you exactly which gaps exist and what to fix first.