- The number of participants and beneficiaries covered under the plan at the end of the plan year.
- The number of individuals offered and receiving Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage.
- Whether the plan offers coverage for employees, spouses, children, and/or retirees.
- The type of group health benefits offered under the plan, i.e., medical/surgical, pharmacy, prescription drug, mental health/substance use disorder, wellness program, preventive care, vision, dental, etc.
- The nature of the plan’s funding and benefit arrangement, and information regarding participant and/or employer contributions.
- Whether any benefit packages offered under the plan are claiming grandfathered status, and whether the plan includes a high deductible health plan, a health flexible spending account, or a health reimbursement arrangement.
- Information regarding rebates, refunds or reimbursements from service providers.
- Stop-loss coverage premiums, information on the attachment points of coverage, individual and/or aggregate claims limits.
- Whether the plan’s summary plan description (SPD), summaries of material modifications (SMM) and summaries of benefits and coverage (SBC) comply with applicable content requirements.
- Information regarding the plan’s compliance with applicable Federal laws, including, for example, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Genetic Information Nondiscrimination Act of 2008 (GINA), the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and ACA.
- Detailed claims payment data, including information regarding how many benefit claims were submitted, appealed, approved and denied during the plan year, as well as the total dollar amount of claims paid during the plan year.
Benefits Think Form 5500 changes could increase obligations for plan sponsors
Published
5 Min Read
Joseph K. Urwitz
Partner
Urwitz focuses his practice on employee benefits, executive compensation and Employee Retirement Income Security Act fiduciary matters.
Sarah Engle
Associate
Engle focuses her practice on employee benefits matters. She counsels clients regarding the design, drafting and operation of tax-qualified pension and profit sharing plans, health and welfare … Read full bio
Megan Mardy
Partner
Mardy advises companies on health and welfare and retirement benefits issues. She has experience with the Affordable Care Act, the Health Insurance Portability and Accountability Act, Consolidated … Read full bio
