My company has just adopted a wellness plan for our employees. Do I need to file a Form 5500 for this plan?
Wellness plans come in all shapes and sizes. Wellness plans may simply offer incentives for employees to lead healthier lives all the way up to providing screenings and reducing the employees contribution towards the cost of their benefits if they meet certain goals. ERISA, which is the law that imposes disclosure requirements on employer-sponsored plans, applies to a wellness program if the wellness program meets the criteria of being a group health plan. ERISA defines a group health plan as a plan that provides medical care.
42 U.S. Code § 300gg–91 – Definitions
(a) Group health plan (1) Definition The term “group health plan” means an employee welfare benefit plan (as defined in section 3(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1002 (1)]) to the extent that the plan provides medical care (as defined in paragraph (2)) and including items and services paid for as medical care) to employees or their dependents (as defined under the terms of the plan) directly or through insurance, reimbursement, or otherwise. (2) Medical care The term “medical care” means amounts paid for— (A) the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body, (B) amounts paid for transportation primarily for and essential to medical care referred to in subparagraph (A), and (C) amounts paid for insurance covering medical care referred to in subparagraphs (A) and (B).
Common Filing Requirement Triggers
Some common initiatives in wellness plans that will cause the plan to be considered a group health plan subject to ERISA are employer-paid immunizations such as flu shots, screenings for blood pressure or cholesterol, and health risk assessments that provide counseling. If a wellness plan is a group health plan, all of ERISA’s requirements such as a plan document, summary plan description and Form 5500 filings must be followed. These ERISA requirements can be easily satisfied by incorporating the wellness plan into the company’s already existing medical plan. If you would like a professional to analyze your wellness program for annual reporting and disclosure requirements under ERISA, please call or Email 5500 Tax Group to discuss your specific situation.
