Year-end compliance is a finite list: known deadlines, known notices and a known set of figures that reset each plan year. Most problems start with an assumption. The broker assumed the TPA filed it, the TPA assumed the employer signed it, and nobody owned the calendar. This checklist is written for a calendar-year plan. Dated figures are for the 2026 plan year closing and the 2027 plan year opening.
Why does year-end compliance need a real process?
Because the penalties are per plan and per day, and the duty sits with the plan even when a vendor does the work. The DOL can assess up to $2,739 a day for a late or missing Form 5500, up to $1,443 for each failure to provide a Summary of Benefits and Coverage, and up to $145 a day per employee for a missing CHIP notice. Those are the 2025 amounts, and they still apply in 2026 because the DOL made no inflation adjustment this year.
Print the tables below and put a name next to every row. A compliance calendar without an owner per line is a wish list.
What is due before December 31?
Before December 31, employers need to finish the gag clause attestation, nondiscrimination testing and plan document amendments, on top of the fall notices.
| Requirement | Deadline | Who owns it |
|---|---|---|
| Medicare Part D creditable coverage notice to individuals | Before October 15 | Plan sponsor |
| Summary of Benefits and Coverage | With open enrollment materials | Plan sponsor and carrier |
| Summary annual report for the prior plan year | 9 months after plan year end, or 2 months after an extended Form 5500 is due (December 15 for a calendar-year plan) | Plan administrator |
| Section 125 and Section 105(h) nondiscrimination testing | Before the plan year closes | Plan sponsor |
| Gag clause attestation | December 31 | Plan sponsor, unless delegated in writing |
| Plan document and SPD amendments for next year’s changes | On or before the effective date | Plan sponsor |
What follows early next year?
Early next year brings the CMS Part D disclosure and ACA reporting, followed by RxDC reporting, the PCORI fee and Form 5500.
| Requirement | 2027 deadline |
|---|---|
| CMS Part D disclosure | Within 60 days after the plan year starts (early March) |
| Form 1095-C furnished to full-time employees, or the alternative website notice posted | March 2, 2027 |
| Forms 1094-C and 1095-C filed electronically with the IRS | March 31, 2027 |
| RxDC reporting for the 2026 reference year | June 1, 2027 |
| PCORI fee on Form 720, self-funded plans | July 31, which falls on a Saturday in 2027, so the next business day, August 2 |
| Form 5500 for the 2026 plan year | August 2, 2027, or October 15, 2027 with a Form 5558 extension |
How do you clear the gag clause attestation?
Confirm who is filing, read the contracts the attestation covers, and keep the CMS confirmation, all before December 31. If you clear one item before the year closes, make it this one. CMS requires an attestation by December 31 each year that your plan’s contracts do not block access to its own cost, quality and claims data.
Two traps catch employers. Fully insured plans assume the carrier filed without confirming it. Self-funded plans attest without reading their TPA and PBM contracts. Reading the contracts is the real work. The attestation is the receipt.
What changes in the 2027 plan limits?
For 2027, the ACA affordability percentage rises to 10.22 percent, and the HSA, HDHP and employer mandate figures all go up. Most errors at this stage are configuration errors: the rules were followed, but the system was never updated. Load these figures into your benefits administration system and enrollment materials.
| Item | 2027 figure | Source |
|---|---|---|
| ACA affordability percentage | 10.22% | Rev. Proc. 2026-26 |
| 4980H(a) penalty, per full-time employee | $3,780 a year | Rev. Proc. 2026-22 |
| 4980H(b) penalty, per employee with a premium tax credit | $5,670 a year | Rev. Proc. 2026-22 |
| HSA contribution limit | $4,500 self-only, $9,000 family | Rev. Proc. 2026-24 |
| HDHP minimum deductible | $1,750 self-only, $3,500 family | Rev. Proc. 2026-24 |
| HDHP out-of-pocket maximum | $8,700 self-only, $17,400 family | Rev. Proc. 2026-24 |
| Excepted benefit HRA maximum | $2,250 | Rev. Proc. 2026-24 |
| ACA out-of-pocket maximum | $12,000 self-only, $24,000 other | CMS 2027 parameters |
Affordability. 10.22 percent is the first time the threshold has been above 10 percent. Run your safe harbor calculation against the new figure instead of rolling last year’s contribution forward. The 4980H(a) penalty applies across your full-time population in any month you fail the 95 percent offer test, so eligibility tracking matters.
Out-of-pocket limits. A high deductible plan has to meet both the ACA limit and the lower IRS limit, so the IRS figure is the one that binds.
Health FSA. For 2026, the IRS set the salary reduction limit at $3,400, with a maximum carryover of $680. The IRS had not published the 2027 figures as of October 27, 2026, so use a placeholder and confirm before materials go to print. Check that your cafeteria plan document matches the grace period or carryover you actually run.
How do you file ACA reporting?
For the 2026 reporting year, furnish Form 1095-C by March 2, 2027 and file Forms 1094-C and 1095-C electronically by March 31, 2027. Under the IRS instructions, you must file electronically if you file 10 or more information returns in total, which covers nearly every applicable large employer.
You can use the alternative furnishing method instead of mailing every statement: post a clear notice on your website by the furnishing deadline, keep it up through October 15, and send a statement within 30 days of any request. Our guides to ACA reporting and Form 1095-C cover the codes.
Which notices need a distribution log?
Notices are the easiest item to prove you missed. Keep a log with dates, methods and recipient groups.
- Summary of Benefits and Coverage with the uniform glossary, plus 60 days’ advance notice of a mid-year material change
- Medicare Part D creditable coverage notice, before October 15
- CHIP premium assistance notice, every year
- Women’s Health and Cancer Rights Act notice, at enrollment and every year
- Newborns’ and Mothers’ Health Protection Act description in the SPD
- HIPAA special enrollment rights notice, at or before enrollment
- HIPAA privacy notice for self-funded plans, with a reminder at least every three years
- COBRA general notice, within 90 days of coverage starting
- Wellness program notices for health-contingent programs, including reasonable alternative standards
- Summary annual report, for plans that file Form 5500
Some states, including California, Massachusetts, New Jersey, Rhode Island and the District of Columbia, have individual mandate reporting of their own that federal filings do not satisfy.
Do your plan documents match the plan you run?
ERISA requires a written plan document and a summary plan description that describe the plan you actually operate. Network changes, new surcharges, a move to reference-based pricing, a pharmacy carve-out or new eligibility rules need to be in writing by their effective date. Check that:
- Every welfare plan, including dental, vision and the health FSA, has a signed plan document and current SPD.
- A summary of material modifications went out for mid-year changes.
- Your wrap document still lists the right carriers and contract numbers.
- The named fiduciary and plan administrator are people who still work for you.
What belongs in the fiduciary review?
Advisor compensation, mental health parity, and transparency and RxDC status belong in the fiduciary review. Filing on time shows you are organized. A documented, prudent process is what ERISA asks of fiduciaries.
Advisor compensation. Brokers and consultants who expect $1,000 or more in compensation must disclose it in advance. Do you have a written disclosure from every advisor touching your plan, and did you review it at a meeting and record a decision?
Mental health parity. The Departments paused enforcement of the new parts of the 2024 rule, but the statute still applies. You still need a written NQTL comparative analysis and must produce it on request.
Transparency and RxDC. Non-grandfathered plans must post machine-readable files that are updated monthly. Confirm the files are live and the link works. For RxDC, confirm in writing who submits each file, since the employer often supplies the premium data.
A health plan fiduciary committee is where this review happens and gets recorded.
When should you run nondiscrimination testing?
Before December 31. Testing after the year closes gives you a diagnosis with no fix.
- Cafeteria plans under Section 125 must pass eligibility, contributions and benefits, and key employee concentration tests. Key employees cannot receive more than 25 percent of total benefits.
- Dependent care assistance programs under Section 129 face a 55 percent average benefits test and a 25 percent limit for owners.
- Self-funded medical plans must pass Section 105(h) eligibility and benefits tests.
Failures land on highly compensated employees, who lose the tax exclusion. If your workforce shifted this year through an acquisition, a reduction or new eligibility rules, test early.
What does a 30-day plan look like?
A 30-day plan gives each week one job: inventory, contracts, numbers and notices, then governance.
- Week one, inventory. List every welfare plan with its plan year, funding, participant count, carrier or TPA and named plan administrator.
- Week two, contracts and attestation. Pull TPA, PBM and network agreements, look for limits on data access, resolve them, then complete the attestation.
- Week three, numbers and notices. Load the 2027 limits, reconcile the notice log, and put the CMS Part D disclosure on the calendar for early March.
- Week four, governance. Hold a documented meeting to review compensation disclosures, testing results, the parity analysis and transparency file status. Record the decisions and who made them.
How Ethos Benefits helps.
Ethos Benefits tracks every federal requirement for its clients’ health and welfare plans through compliance work and the Ethos Fiduciary OS compliance calendar, with an owner, a due date and proof each was done. If you are not sure your plan is ready for year end, a Strategic Analysis starts with your plan documents and vendor contracts.
This page is general information, not legal or tax advice. Figures and deadlines are as of October 27, 2026.