Employee Benefit Plan Audits
Health & Welfare Benefit Plan Audit
Modus helps you get a health and welfare benefit plan audit that meets ERISA and DOL requirements, faster.
A health and welfare benefit plan audit is the annual independent examination required once certain funded welfare plans reach a threshold, and Modus helps sponsors get that audit done faster and with less friction. With Modus, your health and welfare plan audit gets top-firm rigor and AI-native speed on your timeline.
What is a health and welfare benefit plan audit?
A health and welfare benefit plan audit is an independent examination of the financial statements of an ERISA welfare plan, conducted to satisfy the reporting requirements of the Department of Labor. It covers contributions, claims and benefit payments, plan assets held in trust, and internal controls, and results in an opinion on whether the financial statements are fairly stated.
Welfare plans include medical, dental, vision, life, and disability arrangements, as well as health reimbursement and flexible benefit programs.
Who needs a health and welfare benefit plan audit?
The requirement generally applies to large ERISA welfare plans that are funded, such as those holding assets in a trust.
- Plans with 100 or more participants at the beginning of the plan year generally require an audit if they are funded.
- Fully insured and unfunded plans paid from general assets are often exempt.
- Plans with a VEBA or other trust holding assets are typically treated as funded.
- Sponsors should confirm funded status, since it drives the audit requirement.
What a health and welfare benefit plan audit covers
- Employer and employee contributions and premium remittances.
- Claims incurred, claims paid, and incurred-but-not-reported (IBNR) reserves.
- Plan assets held in trust and related investment activity.
- Benefit payments and coordination with third-party administrators.
- Internal controls and compliance with the plan document.
How Modus helps with your health and welfare plan audit
Modus helps you get your health and welfare plan audit done at the speed of business. Its AI-native platform automates the most time-intensive fieldwork and reconciles claims and contribution data across administrators, which is how a Modus-supported audit can target a turnaround of roughly four weeks. Workpapers are source-linked, so each figure traces back to its supporting document.
That efficiency changes your experience. Modus’s platform cuts the document requests and questions your team fields, so your benefits and finance staff spend less time servicing the audit.
Why choose Modus
- Top-firm audit rigor at a middle-market price.
- A target turnaround of roughly four weeks to keep your Form 5500 deadline comfortable.
- Source-linked workpapers that tie claims and contributions to administrator records.
- Up to roughly 50% fewer questions for your team during fieldwork.
Frequently asked questions
Does my health plan need an audit if it is fully insured?
Usually not. Fully insured and unfunded welfare plans paid from the employer’s general assets are often exempt from the audit requirement, even with 100 or more participants. Funded plans that hold assets in a trust or VEBA generally do require an audit.
How are IBNR claims handled in the audit?
Incurred-but-not-reported claim reserves are a key estimate the audit examines and corroborates against actuarial and administrator data. Modus’s platform reconciles claims data early so reserve estimates can be evaluated without last-minute scrambling.
When is the audit due?
The audited financial statements attach to your Form 5500, generally due seven months after the plan year-end, extendable by two and a half months via Form 5558. Starting early leaves room for a clean, unhurried process.
Why Modus
Audits at the speed of business
Modus helps you get a faster, higher-quality Health & Welfare Benefit Plan Audit — top-firm rigor, source-linked workpapers, and far fewer questions for your team.
More Employee Benefit Plan Audits
Related services
Ready to talk about your Health & Welfare Benefit Plan Audit?
Get a fast, fixed-scope proposal from a Modus audit team.