ALERT / SEPTEMBER 10, 2026

Upcoming key compliance deadlines and reminders for fourth quarter 2026

13 MIN READ

As we enter the fourth quarter of 2026, employers sponsoring health and welfare benefit plans should turn their attention to several important year-end compliance obligations and planning opportunities. The final months of the year often serve as a critical period for completing annual disclosures, preparing for upcoming reporting requirements, and ensuring employee communications and enrollment materials accurately reflect plan terms and regulatory requirements for the 2027 plan year.

This quarter's compliance focus includes year-end benefit communications, Medicare Part D disclosure requirements, extended Form 5500 filing deadlines, preparation for ACA reporting season, and completion of annual CMS attestations. Employers should also use this period to verify that plan documents, participant notices, open enrollment materials, and administrative practices reflect recent regulatory developments and operational changes implemented throughout the year.

We have organized the reminders into standard federal deadlines and select state and local deadlines in chronological order. Deadlines may or may not apply to your group, depending on the employer and plan characteristics. In addition to required filings and notices, employers should consider using the final quarter of the year to confirm vendor responsibilities, review plan documentation, assess any outstanding compliance projects, and prepare for 2027 reporting and disclosure requirements.

STANDARD FEDERAL DEADLINES

Oct. 2 - Distribute notice of Qualifying Small Employer Health Reimbursement Arrangement (QSEHRA) (For employers offering calendar year QSEHRAs)

Applies to small employers (not subject to the ACA employer mandate) who sponsor a QSEHRA, in lieu of any other group medical coverage, that reimburses employees for individual market medical insurance premiums on a tax-free basis.

The notice must be provided to each “eligible employee” regardless of enrollment status and must include the employee’s maximum HRA benefit for the year, among other information. The notice is due at least 90 days before the beginning of the new plan year. The deadline is for employees who are eligible for the upcoming calendar year; for those who gain eligibility at a later date, the notice should be provided no later than the date the employee gains eligibility to participate in the QSEHRA.

A model notice is available from your Lockton account service team.

Oct. 2 - Distribute notice of Individual Coverage Health Reimbursement Arrangement (ICHRA) (For employers offering calendar year ICHRAs)

Applies to employers of any size who offer an ICHRA, in lieu of any other traditional group medical coverage, that reimburses employees for individual market medical insurance premiums or Medicare premiums.

The notice must be provided to each “eligible employee” regardless of enrollment status. It must include information about the benefits provided by the ICHRA and the effect of the ICHRA coverage on the ability to qualify for federal subsidies in an individual market.

The notice is due, generally speaking, at least 90 days before the beginning of the new plan year. The deadline is for employees who are eligible for the upcoming calendar year; for those who gain eligibility at a later date, the notice should be provided no later than the date the employee gains eligibility to participate in the ICHRA.

A model notice Is available from your Lockton account service team.

Oct. 2 - Submit Medicare Part D subsidy application to CMS to obtain Part D subsidy for 2026 plan year (For calendar-year retiree drug plans)

Applies to ERISA and non-ERISA plans seeking federal subsidies for providing retiree drug coverage. Generally, the application deadline is 90 days prior to the beginning of the plan year. An extension of approximately 30 days can be requested from the Center for Medicare & Medicaid Services (CMS) prior to the application deadline.

Oct. 15 - Distribute notices of creditable and/or non-creditable coverage (If not provided in the previous 12 months)

Provide this notice to employees, retirees and dependents enrolled in Medicare and also enrolled (or seeking enrollment in) the employee’s group medical plan.

Most employers supply these notices at open enrollment, and such notices are deemed given for the next 12 months unless there’s a material change in the creditable or non-creditable nature of the coverage. Thus, if distributed in enrollment packets during the previous 12 months (and there’s no material change in the Rx coverage), the mid-October deadline may be ignored.

These notices may be combined with other notices but must be "conspicuous.” There must be a text box atop the packet noting in 14-point font that the packet includes a Medicare Part D notice. The notice may be mailed or hand-delivered; electronic distribution is possible, but special consent rules apply.

Oct. 15 - File Form 5500 for the prior calendar year plan year (If filing under an extension from a July 31 deadline)

Applies to ERISA plans.

Form 5500 extensions are available by filing a Form 5558 with the DOL on or before the filing’s initial due date. Calendar year plans with a July 31, 2026 deadline for 2025 Forms 5500 and that obtained a 2 1/2 month extension via Form 5558 should file by Oct. 15, 2026.

Dec. 15 - Distribute summary annual reports (SARs) (If Form 5500 for a calendar year plan was filed under an extension)

Applies to calendar-year ERISA plans that filed Form 5500 under an extension.

For non-calendar year plans, the SAR deadline is two months after the plan’s extended 5500 deadline.

Dec. 29 - Last day for employers to distribute portion of MLR rebate

The employer must distribute the portion of an MLR Rebate that is considered plan assets within 90 days of receiving the rebate (by Dec. 29 if received on Sept. 30). Otherwise, the employer may be subject to the general ERISA trust requirements. Plan sponsors that receive a rebate prior to Sept. 30 may need to adjust their deadline to use the rebate.

For more information see Lockton’s Guide to Medical Loss Ratio (opens a new window).

Dec. 31 - Submit to CMS the gag clause prohibition attestation (GCPCA)

Under the Transparency provision of the Consolidated Appropriations Act of 2021 (CAA), plans and issuers must annually submit to CMS an attestation that the plan or issuer is in compliance with the gag clause prohibition.

The first gag clause prohibition attestation was due by Dec. 31, 2023, covering the period beginning Dec. 27, 2020, or the effective date of the group health plan coverage (if later), through the date of attestation. Subsequent attestations, covering the period since the last preceding attestation, are due by Dec. 31 of each year thereafter.

Attestations are collected by CMS via the online portal (opens a new window).

Dec. 31 - Distribute annual Women's Health and Cancer Rights Act notice (For calendar year plans)

Applies to ERISA and non-ERISA plans.

The notice must be provided to each employee, regardless of eligibility or enrollment status, and is best provided as a separate document, even if offered with enrollment materials. It should be provided by the last day of the plan year preceding the year to which the notice relates.

A model notice is available through your Lockton account service team and is updated periodically by federal authorities.

Dec. 31 or upon request - Provide nondiscrimination notice; also must post on website and in physical location

Applies to entities covered by Section 1557 of the Affordable Care Act, such as:

Healthcare providers receiving funding from the Department of Health and Human Services (this includes providers receiving Medicare or Medicaid payments)
Employers receiving Medicare Part D reimbursements for their post-65 retiree drug coverage.

The obligation is to include in these documents a nondiscrimination notice apprising employees of the employer’s obligation to comply with section 1557.

First day of open enrollment - Distribute the Summary of Benefits and Coverage (SBC)

Applies to ERISA and non-ERISA plans.

The SBC must be provided to benefit eligible employees at open enrollment if employees must make affirmative benefit elections. If employees do not need to make affirmative benefit elections (automatic re-enrollment), the SBC must be provided 30 days prior to the beginning of the plan year.

First day of open enrollment - Michelle’s Law notice

Applies to ERISA and non-ERISA plans.

The notice must be provided at open enrollment if the plan covers full-time students beyond age 26.

First day of open enrollment - Distribute HIPAA special enrollment notice

Applies to ERISA and non-ERISA plans.

Provide to participants. Best to insert into enrollment packets. Model notices are available on the DOL’s EBSA website and from your Lockton account service team. Notice may be provided electronically in accordance with DOL requirements.

The notice must also be provided when coverage is initially offered.

First day of open enrollment - Distribute HIPAA privacy notice

Applies to ERISA and non-ERISA plans.

Required of sponsors of self-insured health plans, including partially self-insured health plans (e.g., the employer reimburses, as through an HRA, a portion of an otherwise insured plan’s deductible). Provide to all enrolled individuals. However, delivery to the enrolled participant is deemed to be delivery to all their dependents. If dependent requests a copy of the notice, however, the plan must supply it.

Best to include in enrollment packets. Model notices are available from your Lockton account service team. Notice may be provided electronically, but only if the individual recipient consents to receive it electronically. A plan that has a website is required to post its notice of privacy practices prominently on the website and make the notice available electronically through the website.

Insured plans, where the sponsor is “hands on” PHI, are required to have a notice of privacy practices, but the sponsor (on behalf of the plan) is not required to distribute it – only to provide it upon request.

First day of open enrollment - Distribute notice of availability of alternative standards to maintain a wellness program

Applies to ERISA and non-ERISA plans.

When an employer operates an activities-based or outcomes-based wellness program subject to the ACA, wellness program materials must include a notice that where an individual is unable to satisfy the employer’s desired standard (or it would be unwise to try), the employer will fashion an individualized, alternative standard for the individual.

A specific timing or method for distribution is not addressed in the regulations; however, such disclosure must be included in all plan materials describing the terms of the program (written or online).

Regulations include model language that can be used to satisfy the disclosure requirement.

Plan materials are not required to describe a specific reasonable alternative standard, only the availability of one. The plan may accept the recommendations of the individual’s physician as the appropriate alternative standard and, in some cases, may be required to do so.

Other notices that may be included at open enrollment

COBRA general notice - must be provided when plan coverage first begins, but also can be provided at OE.
Notice of grandfathered status (if applicable) - provide to participants during OE with respect to plans that maintained grandfathered status.
Notice of right to designate primary care physician, and no preauthorization requirement for OB/GYN care - provide to all participants in a non-grandfathered plan that requires designation of a primary care provider or that provides coverage for OB/GYN care and requires designation of a primary care provider.

SELECT STATE AND LOCAL DEADLINES

Oct. 1 - Managed Care Organization Payor Assessment: Pay monthly assessment fee for services rendered in Massachusetts

The Massachusetts Managed Care Organization (MCO) Payor Assessment applies to managed care organizations, including carriers and self-funded plans with Massachusetts members.

Oct. 1 - New Mexico Vaccine Purchasing Act: Submit quarterly covered lives assessment payment

The New Mexico Vaccine Purchasing Act (VPA) applies to fully insured plans and self-insured ERISA plans (including TPAs) covering children under age 19 who reside in New Mexico.

Oct. 25 - Vermont Health Care Fund Contribution Assessment: Submit quarterly reporting and assessment payment for previous quarter

The HCFCA is a quarterly employer assessment designed to support Vermont’s healthcare programs. Employers with five or more full-time equivalent (FTE) employees in Vermont who do not offer health coverage to all employees may owe this assessment.

Oct. 30 - San Francisco Health Care Security Ordinance: Fully insured plans to make San Francisco HCSO contributions for any Q3 expenditure shortfalls

Applies to all employers subject to the San Francisco Healthcare Security Ordinance.

Oct. 30 - Michigan Insurance Provider Assessment Act: Pay quarterly assessment based on annual notice

Health insurers and certain managed care plans must pay quarterly assessments based on prior-year member months.

Oct. 30 - Rhode Island Vaccine Assessment Program: Submit quarterly covered lives report and assessment payment for previous quarter

The Rhode Island Vaccine Assessment Program (RIVAP) requires certain health plans and payers to fund the state’s universal vaccine purchasing program through quarterly assessments based on covered lives.

Oct. 31 - Washington Cares tax: Fully insured and self-insured ERISA plans file report and remit payment of payroll tax withholdings from Q3 for Washington workers

Applies to fully insured and self-insured ERISA plans. Employers collect premiums from employees via after-tax payroll withholdings to support WA Cares long-term care insurance program.

Nov. 2 - Massachusetts Managed Care Organization Payor Assessment: Pay monthly assessment fee for services rendered in Massachusetts

The Massachusetts Managed Care Organization (MCO) Payor Assessment applies to managed care organizations, including carriers and self-funded plans with Massachusetts members.

Nov. 15 - Alaska Vaccine Assessment: Submit quarterly covered lives reporting and assessment

Employers and other assessable entities (health insurers, TPAs, self-funded ERISA plans) must report covered lives and vaccine usage data to the Alaska Vaccine Assessment Program (AVAP).

Nov. 15 - Maine Vaccine Board: Submit quarterly covered lives reporting and payment for previous quarter

Nov. 15 - New Hampshire Vaccine Association: Submit reporting and payment for previous quarter

Health insurers, TPAs, and other assessable entities must report covered lives under age 19 and pay quarterly assessments.

Nov. 15 - New Hampshire Health Plan: Submit covered lives reporting and assessment for previous quarter

The New Hampshire Health Plan (NHHP) Assessment funds key state health initiatives. Health carriers, TPAs, and other assessable entities must report covered lives and pay quarterly assessments.

Nov. 15 - Vermont Vaccine Purchasing Program: Submit reporting and assessment payment for previous quarter

The Vermont Vaccine Purchasing Program (VVPP) is Vermont’s universal vaccine program. It applies to health insurers, self-insured employers, TPAs, HMOs, and other entities that cover Vermont lives.

Nov. 15 - WAPAL Fund: Submit covered lives reporting and assessment for previous quarter

Applies to all assessed entities with covered lives in Washington, including Washington employers and out-of-state employers with covered lives in Washington. Applies to fully insured and self-insured ERISA plans.

Dec. 1 - Massachusetts Managed Care Organization Payor Assessment: Pay monthly assessment fee for services rendered in Massachusetts

The Massachusetts Managed Care Organization (MCO) Payor Assessment applies to managed care organizations, including carriers and self-funded plans with Massachusetts members.

Nov. 15 – Dec. 15 - Massachusetts HIRD Reporting: File Massachusetts Health Insurance Reporting Disclosure Form

Applies to any employer that reported six or more employees (includes all employment categories) in any Massachusetts unemployment wage report during the past 12 months.

Not legal advice: Nothing in this alert should be construed as legal advice. Lockton may not be considered your legal counsel, and communications with Lockton's Compliance Consulting group are not privileged under the attorney-client privilege.