Form preview

Get the free Schedule A (Form 5500) - dol

Get Form
This schedule is required to be filed under section 104 of the Employee Retirement Income Security Act of 1974 (ERISA). It provides information concerning insurance contract coverage, fees, and commissions
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign schedule a form 5500

Edit
Edit your schedule a form 5500 form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your schedule a form 5500 form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing schedule a form 5500 online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use our professional PDF editor, follow these steps:
1
Log in to account. Start Free Trial and register a profile if you don't have one yet.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit schedule a form 5500. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
pdfFiller makes working with documents easier than you could ever imagine. Create an account to find out for yourself how it works!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out schedule a form 5500

Illustration

How to fill out Schedule A (Form 5500)

01
Begin by gathering necessary information about the plan, including the plan sponsor's details.
02
Indicate the plan's basic information, such as the plan name, number, and year.
03
Provide information regarding the insurance carriers and policies related to the plan.
04
Enter detailed data regarding premiums paid, including the type of insurance and the coverage period.
05
Report any other significant information regarding the plan's health insurance program.
06
Review the completed Schedule A for accuracy and completeness before submitting with Form 5500.

Who needs Schedule A (Form 5500)?

01
Any employee benefit plan that provides health insurance and is subject to ERISA regulations needs to file Schedule A (Form 5500).
02
This includes both single-employer and multi-employer health plans.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.7
Satisfied
62 Votes

People Also Ask about

This document contains the instructions for completing Schedule A of the Form 5500, which is used to report information concerning insurance contract coverage, fees, and commissions for employee benefit plans.
Page 1 of 1 The 5500 series of tax forms are prepared by retirement plans. They report the business activity, investments, expenditures and earnings of the plan for the year.
The employer maintaining the plan or the plan administrator of a Pension or Welfare benefit plan covered by ERISA. File Form 5500 to report information on the qualification of the plan, its financial condition, investments and the operations of the plan.
Form 5500's “participant” count includes only participating employees and former employees, excluding spouses and dependents. Conversely, Schedule A's “covered persons” count includes everyone covered under the benefit, including spouses and dependents.
Schedule As are typically provided by insurance carriers for insured benefits. Schedule C provides details on the fees associated with the plan and is typically only provided in the event the reportable fees exceed $5,000.
Schedule As are typically provided by insurance carriers for insured benefits. Schedule C provides details on the fees associated with the plan and is typically only provided in the event the reportable fees exceed $5,000.
Most 401(k) plan sponsors are required to file an annual Form 5500, Annual Return/Report of Employee Benefit Plan. For an explanation of how to file your Form 5500 return, in addition to the EFAST electronic filing requirements, visit EFAST2 Filing.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Schedule A (Form 5500) is a form used in the United States to report the information about an employee benefit plan's insurance contracts and to disclose funding and actuarial information.
Plan administrators of certain employee benefit plans that hold insurance contracts must file Schedule A as part of their Form 5500 filing, specifically plans with covered benefits provided through insurance.
To fill out Schedule A, you must gather information about the insurance contracts, including details like the type of insurance, policy numbers, and the financial information related to these contracts, then complete the form following the instructions provided by the IRS.
The purpose of Schedule A is to provide the Department of Labor and other government agencies with important information about the insurance funding of employee benefit plans, ensuring transparency and compliance with federal regulations.
Information that must be reported includes details about the insurance policies, premiums paid, benefits provided, any changes in coverage, and other relevant financial information pertaining to the insurance arrangements for the benefits offered under the plan.
Fill out your schedule a form 5500 online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.