Form 5500 · Employee benefit plan · SALT LAKE CITY, UT
BRISTOL HOSPICE
The filing calls this plan BRISTOL HOSPICE WELFARE PLAN.
BRISTOL HOSPICE of SALT LAKE CITY, UT spreads its employee benefits across 8 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is LOCKTON COMPANIES, LLC. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 7 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-3688586 · plan 501 · plan year 2025, filed Jul 9, 2026
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699 other employer plans in Utah 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
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits.
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 8 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 639 people.
Reported premium across the insured contracts is $11,517,408, with $22,840 in disclosed broker commissions — about 0.2% 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.
LOCKTON COMPANIES, LLC is the broker of record on 4 of the 8 contracts; the rest name a different broker or none.
8 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., HAWAII MEDICAL SERVICE ASSOCIATION, METROPOLITAN LIFE INSURANCE COMPANY and STANDARD INSURANCE COMPANY. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| RELIASTAR LIFE INSURANCE COMPANY | — | 1,212 | Jan 1, 2026 | $456,803 | $22,840 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 639 | Jan 1, 2026 | $5,651,031 | $0 |
| HAWAII MEDICAL SERVICE ASSOCIATION | Health, Dental, Vision | 549 | Jan 1, 2026 | $1,969,100 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | Dental, Vision | 3,030 | Jan 1, 2026 | $1,319,079 | $0 |
| STANDARD INSURANCE COMPANY | Life, Disability | 3,824 | Jan 1, 2026 | $1,244,171 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF COLORADO | Health | 54 | Jan 1, 2026 | $505,118 | $0 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | Health | 54 | Jan 1, 2026 | $372,088 | $0 |
| VISION SERVICE PLAN | Vision | 0 | Jan 1, 2026 | $18 | $0 |
Premium and claims on this contract
STANDARD INSURANCE COMPANY, contract 163959. For the contract year on this filing, the carrier reported $1,244,171 in premium earned and $664,644 in claims incurred. Dividing one by the other gives 53%.
- STANDARD INSURANCE COMPANY, contract 163959 reported $577,841 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
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