As we head into August and prepare for open enrollment, this is a good opportunity to share a few compliance reminders. Employers sponsoring group health plans should review upcoming compliance deadlines and confirm that vendors, administrators, and internal stakeholders are prepared to meet all reporting, disclosure, and documentation requirements. Several significant deadlines occur during the third quarter, making this an ideal time for a mid-year compliance checkup.
Key Third Quarter Deadlines
July 21, 2026
- Form 5500 - The filing is due for plan years that ended on December 31, 2025 (for calendar-year ERISA plans with 100 or more participants at the beginning of the plan year). Employers should confirm that the filing has been completed or ensure that an extension has been requested using Form 5558. The extension will be automatic and will extend the deadline to October 15, 2026. For non-calendar-year plans, the deadlines are seven months after the end of the plan year (with a potential 2.5-month extension).
- PCORI Fee Payment - This filing is due using IRS Form 720 for applicable self-funded health plans and health reimbursement arrangements (HRAs). Plan sponsors should verify covered life counts and confirm filing responsibilities.
September 1, 2026
- Medical Loss Ratio (MLR) Rebate Review - Employers sponsoring fully insured group health plans should monitor for annual MLR rebate notices from their insurance carriers (employers that sponsor self-funded plans will not be affected by this requirement). MLR rebates are issued when an insurer fails to spend the required percentage of premium revenue (generally 80% in the individual and small group markets or 85% in the large group market) on medical care and activities that improve healthcare quality. Employers that have received an MLR rebate in prior years may be more likely to receive one again and should remain alert for communications from their insurance carrier. Carriers may also send rebate-related notices directly to plan participants.
Upon receiving an MLR rebate, employers should determine whether any portion of the rebate constitutes ERISA plan assets. If so, the rebate must be used solely for the benefit of plan participants and beneficiaries in accordance with ERISA fiduciary requirements. Depending on the circumstances, the rebate may be distributed to participants, applied toward future participant premium contributions, used to enhance plan benefits, or applied to reasonable plan administrative expenses, provided the use is consistent with applicable ERISA guidance.
- Summary Annual Report (SAR) Distribution - This is generally due for calendar-year plans by September 30, or December 15 if the Form 5500 deadline was extended.
Additional Compliance Items to Address Before Fourth Quarter
While not all of these items have third-quarter deadlines, employers should begin preparing now for important fourth-quarter obligations:
- Review Medicare Part D creditable and non-creditable coverage determinations and prepare participant notices due before October 15. These notices are often included in the plan's open enrollment materials.
- Confirm other annual notices are included with open enrollment materials, including:
- Women's Health & Cancer Rights Act (WHCRA) Notice
- Children's Health Insurance Program (CHIP) Notice (where applicable)
- Grandfathered Plan Notice (if applicable)
- Notice of Patient Protections (if applicable)
- Verify that plan documents, summary plan descriptions (SPDs), eligibility provisions, and vendor information remain current.
Conclusion
As open enrollment approaches, a proactive compliance review can help identify potential issues before deadlines arrive. Employers should take the time now to confirm required filings, notices, and plan documentation are in place, which can help support a smooth and successful enrollment season. Reach out to your broker or service team with any questions.
This Compliance Alert is provided by World Insurance for general informational purposes only. It is not intended as, and should not be relied upon as, legal or tax advice. Please consult your benefits counsel for guidance specific to your plan.