What can Form 5500 data tell a benefits seller, and what does it miss?

Form 5500 data in short: what it covers and what it misses

A Form 5500 tells you about health and welfare plans that had to submit one, and only months after their plan year ended. Most small insured health plans never submit, so most small employers are not in the data at all. And no line on the form says whether a benefits decision is open, who owns it now, or whether a new broker is welcome.

The Form 5500 series is the annual report the Department of Labor, the IRS and PBGC built so benefit plans can meet ERISA and tax-code reporting rules. The reports are public: DOL's 2025 instructions say Schedule A and its attachments "are open to public inspection", and DOL's EFAST2 website offers a Form 5500 Series Search for finding submitted reports (checked 2026-10-06).

This page is for the broker, ICHRA platform or benefits vendor who already works from these reports. It covers who submits, who never appears, what Schedule A really says, how old the information is, and what the form cannot tell you. It is context on a federal rule, not legal or compliance advice: check the rule's own text and your counsel.

Who has to file a Form 5500 for a health plan

The report comes from "the employer maintaining the plan or the plan administrator" of a pension or welfare plan covered by ERISA (IRS Form 5500 Corner, updated 2026-07-20). Health plans are welfare plans, and DOL's 2025 instructions start broad: "All welfare benefit plans covered by ERISA are required to file a Form 5500 except as provided in this section."

So the default is that a health plan reports, and the real question is which exemption takes it out. DOL's 2026 Report to Congress sums it up: "Generally, private-sector employer group health plans must file a Form 5500 only if they cover 100 or more participants, hold assets in trust, or constitute a plan MEWA." Three details decide most cases:

• Size is counted in participants at the beginning of the plan year, not employees on payroll (29 CFR 2520.104-20, eCFR current as of 2026-10-02).
• Plans that must file a Form M-1, which covers multiple employer welfare arrangements, report "regardless of the plan size or type of funding" (2025 instructions).
• Small plans that do report may be able to use the short form, Form 5500-SF, if they meet its conditions. It carries much less broker detail (2025 short-form instructions).

Why you can't find a small employer's Form 5500

Because most small health plans are exempt. DOL's 2025 instructions say not to submit a Form 5500 for a welfare plan that "covered fewer than 100 participants as of the beginning of the plan year and is unfunded, fully insured, or a combination of insured and unfunded, and which is not subject to the Form M-1 requirements."

Participants are not employees. Covered former employees on COBRA count, and "Covered dependents are not counted as participants" (2025 instructions). Example, invented for this page: a design studio has 130 employees, but on the first day of the plan year its fully insured medical plan covers 85 of them and no one on COBRA. That is 85 participants, under 100, so the plan submits nothing even though the company has more than 100 employees.

Plans also move in and out. One that drops under 100 stops reporting, and one that grows back to 100 or more must start again and enter code 4S on line 8b that year (2025 instructions).

Some employers never appear at any size. DOL's 2026 report says "Governmental and church plans, regardless of size, are not subject to the jurisdiction of the Department and are not required to file a Form 5500." If you sell to cities, school districts or church bodies, this data does not cover them.

How many health plans submit a Form 5500? About 87,700 of an estimated 2.8 million (2023)

DOL's 2026 Report to Congress estimates "about 2.8 million ERISA-covered group health plans covering approximately 135 million participants and beneficiaries in 2023," and says "Only about 87,700 plans covering 88 million participants filed a 2023 Form 5500." Divide 87,700 by 2,800,000 and you get about 3.1 percent: fewer than 1 in 30 ERISA group health plans submitted a 2023 report.

Those are plans, not employers. One employer can sponsor more than one plan, and the 2.8 million is DOL's own estimate. The 3.1 percent is a share of plans, never a share of employers.

DOL is blunt about the hole: most small plans "do not hold assets in trust and, therefore, are not required to file a Form 5500," so its report "excludes a large majority of small health benefit plans." The small plans that do report are unusual. DOL says small self-insured plans, most of which take part in a non-plan multiple employer welfare arrangement, made up 31 percent of all Form 5500 health plan reports in 2023. Do not treat the small plans you find as a sample of small employers.

How old is Form 5500 data? Deadlines, extensions and the lag

The report is due "the last day of the seventh month after the plan year ends (July 31 for a calendar year plan)" (IRS, updated 2026-07-20). Form 5558 gives one extension of "up to 2 ½ months after the normal due date" (IRS, updated 2026-05-28), and the form itself caps the new date at the 15th day of the third month after the normal due date. For a calendar-year plan, that arithmetic gives October 15. A second route tied to the employer's tax extension cannot run "beyond a total of 9½ months beyond the close of the plan year" (2025 instructions).

The insurance details can be older than the plan year. Schedule A information "should pertain to the insurance contract or policy year ending with or within the plan year" (2025 instructions).

Worked example, using only those rules. A calendar-year plan's 2025 plan year ran January 1 to December 31, 2025. Its report was due July 31, 2026, and with an extension can arrive as late as October 15, 2026. So on 2026-10-06, an extended report for that year can still be on time. When it arrives, a policy year that matches the plan year describes coverage that started on January 1, 2025, about 21 months earlier. If the insurance contract runs July 1 to June 30, the 2025 report carries the contract year that began July 1, 2024.

The full picture runs later still: DOL's 2026 Report to Congress covers 2023, "the latest year for which complete data are available." A policy-year end date read off an old report is a date, not a decision. The X-dates and renewal dates guide covers what a date can and cannot tell you.

Form 5500 Schedule A: carrier, policy year and everyone the insurer paid

Schedule A, the insurance schedule, holds most of what a benefits seller reads. DOL's 2025 instructions require it for every plan that submits a Form 5500 "if any benefits under the plan are provided by an insurance company, insurance service, or other similar organization."

Commissions are amounts "paid by an insurer" and charged to the contract, and fees include service fees, consulting fees, finders fees and persistency bonuses (2025 instructions).

Three gaps matter. DOL says "Do not file Schedule A for a contract that is an Administrative Services Only (ASO) contract." Schedule C, the service-provider schedule, is for large plans, lists people paid $5,000 or more, and leaves out anyone paid only through commissions and fees already on Schedule A, plus payments the employer makes directly that the plan does not reimburse. And the short form gives small plans one yes or no question, line 10e, on whether an insurer paid fees or commissions to brokers or agents, plus a total. The 2025 short form has no field for their names.

For each contract, the 2025 Schedule A asks for:

• The carrier's name, EIN and NAIC code, and the contract number.
• The "Approximate number of persons covered at end of policy or contract year".
• The policy year, "From" and "To". The start date is left blank when separate contracts covering individual employees are grouped, and an insurer that keeps records by plan year may report the plan year instead.
• Premiums paid to the carrier, and total commissions and fees.
• Each agent, broker or other person the insurer paid, with commissions and fees, listed "in descending order of the amount paid."

Does Form 5500 show the broker of record? No

There is no broker-of-record field on the 2025 Schedule A. It lists everyone the insurer paid, largest first, for a contract year that ended before the report was even due. The top name was paid the most for that contract year. It says nothing about who holds the account today.

The top name goes wrong in four common ways. A broker change after that contract year will not show until a later report. A broker paid a flat fee directly by the employer, and not reimbursed by the plan, appears on neither Schedule A nor Schedule C. A retirement plan's report names that plan's advisers, not the medical broker. And the short form has no names at all.

Most insurers will discuss an account only with the agent of record, and an employer that wants a different agent submits a revised agent of record letter to the insurer (IRMI glossary, accessed 2026-10-06). The broker of record letter guide covers how that change works.

What Form 5500 data cannot tell a seller

Even a full report leaves out things sellers most want. Funding type is the big one: DOL's 2026 report says "The Form 5500 does not explicitly disclose whether a health plan is self-insured." Stop-loss the employer pays for only from its general assets "generally are not plan assets and are not reportable on Schedule A," and DOL says reports "often understate the use of stop-loss insurance." The level-funded vs fully insured guide covers funding checks.

The full list:

• Anything about plans that do not submit: most small insured or unfunded plans, and every governmental and church plan.
• What is true now, since a report can arrive up to 9 and a half months after the plan year ends.
• Who the broker of record is today, and any fee-only adviser the employer pays directly.
• Whether a plan is self-funded or level-funded, and whether the employer bought stop-loss.
• ASO arrangements, which get no Schedule A.
• What employees pay per paycheck or by coverage tier. Contributions appear only as plan-level totals, and only where the financial sections are completed.
• Whether a decision is open: whether the employer is reviewing coverage or advisers, who owns that decision now, or any proposal deadline. No line on the 2025 forms records these.

How to read Form 5500 data: the seller's questions, answered

Use this before you treat a report as a reason to call. All sources were opened on 2026-10-06.

What benefits brokers can use besides Form 5500 data

Clean's own internal database goes well beyond Form 5500 filings.

A renewal date tells you when coverage ends. Clean looks for evidence that a decision is actually open, who owns it, and whether a new broker can take part. When Clean cannot confirm something, such as the funding type, PEO status or whether a new broker is welcome, it marks it unknown instead of guessing.

Clean finds employers with a real reason to review their benefits, shows the evidence behind each one, and names the people who own the decision. It does not need employee health records, census files or claims data, and it can research the employers already on your list as well as find new ones. The employee benefits sales guide and buyer signals cover the moments that open a decision.

If you sell benefits, coverage or ICHRA to employers, see Clean for insurance and book a demo to see employers in your market with a real reason to review their benefits, and who owns the decision at each.