Form 5500 · Employee benefit plan · CARLISLE, PA
AHOLD USA, INC.
The filing calls this plan RETIREE MEDICAL PLAN FOR THE COMPANIES OF ADUSA.
AHOLD USA, INC. of CARLISLE, PA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MERCER HEALTH & BENEFITS ADMIN LLC. Coverage is written through AETNA LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 53-0073545 · plan 553 · plan year 2023, filed Jul 24, 2024
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2,778 other employer plans in Pennsylvania have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision and life; the largest, with AETNA LIFE INSURANCE COMPANY, covers 422 people.
Reported premium across the insured contracts is $980,209, with $159,125 in disclosed broker commissions — about 16% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
MERCER HEALTH & BENEFITS ADMIN LLC is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including AETNA LIFE INSURANCE COMPANY, METROPOLITAN LIFE INSURANCE COMPANY and FIDELITY SECURITY LIFE INSURANCE COMPANY. AETNA LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health | 422 | Jan 1, 2024 | $566,612 | $159,125 |
| METROPOLITAN LIFE INSURANCE COMPANY | Life | 663 | Jan 1, 2024 | $238,508 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | Dental | 241 | Jan 1, 2024 | $122,283 | $0 |
| AETNA LIFE INSURANCE COMPANY | Health | 25 | Jan 1, 2024 | $35,560 | $0 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 257 | Jan 1, 2024 | $17,246 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 20,147 employees, 632 recordable cases, 11,934 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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Renewal calendar
2,778 other employer plans in Pennsylvania are January 1 renewals (policy year ends December).
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