As the third quarter of 2026 unfolds, employers sponsoring health and welfare plans, especially those governed by ERISA, must navigate a complex web of compliance deadlines and reporting obligations. This period is crucial for avoiding penalties and ensuring adherence to federal laws. Here's a comprehensive breakdown of the key compliance deadlines and reminders to keep in mind, with a focus on the third quarter.
PCORI Tax Submission
One of the most pressing deadlines is the PCORI tax submission, due July 31. This tax applies to insured and self-funded plans, with the plan sponsor responsible for it in the case of self-funded plans. The amount varies depending on the plan year, ranging from $3.84 to $3.47. It's essential to note that the PCORI tax does not apply to most 'excepted benefits' or health reimbursement arrangements (HRAs) where the HRA and associated medical plan are self-insured and share the same plan year. However, employers must be cautious as the PCORI tax cannot typically be paid with ERISA plan assets, and it is the employer's responsibility to ensure compliance.
Form 5500 Filing
Form 5500 is a critical filing for ERISA plans with calendar-year plans, due July 31 annually unless an extension is obtained. This form summarizes the plan's financial performance for the previous year and is filed electronically through the Department of Labor's (DOL) EFAST2 portal. Welfare plans that are fully insured, unfunded, or a combination of both, with fewer than 100 participants covered on the first day of the ERISA plan year, are exempt from filing. However, extensions are available by filing Form 5558 with the DOL, providing an additional 2.5 months to complete the filing.
Summary Annual Report (SAR) Distribution
The SAR, a summary of the plan's financial performance for the previous calendar year, must be distributed to participating employees, former employees, COBRA beneficiaries, and Qualified Medical Child Support Order (QMCSO) recipients by September 30. This requirement does not apply to self-funded plans that pay benefits exclusively from the employer's general assets, provided those contributions are made through a Section 125 cafeteria plan. The SAR language is standard, and electronic disclosure is an option, adhering to the DOL's requirements.
Medical Loss Ratio (MLR) Rebates
Issuers of health plans must adhere to the Medical Loss Ratio (MLR) regulations, spending a minimum percentage of premium dollars on medical care and healthcare quality improvement. Non-compliance results in rebates to consumers, which must be provided by September 30. Plan sponsors should be aware of their legal options for utilizing these rebates and should aim to use them within three months to avoid ERISA trust requirements.
Additional Filings and Assessments
The third quarter also brings various state and local deadlines. For instance, July 1 marks the deadline for the Managed Care Organization Payor Assessment in Massachusetts, while July 25 is the due date for the Vermont Health Care Fund Contribution Assessment. Employers must also navigate the San Francisco Health Care Security Ordinance (HCSO) and the Rhode Island Vaccine Assessment Program (RIVAP) deadlines. These state-specific obligations highlight the complexity of compliance for employers across different regions.
In conclusion, the third quarter of 2026 demands meticulous attention to detail from employers, especially those with health and welfare plans. By staying informed about these compliance deadlines and obligations, employers can avoid penalties and ensure a smooth operational process. As always, coordination with service providers and internal stakeholders is vital to meeting these requirements accurately and on time.
