Form 5500 · Employee benefit plan · ROANOKE, VA
CARILION CLINIC
The filing calls this plan CARILION CLINIC WELFARE BENEFIT PLAN.
CARILION CLINIC of ROANOKE, VA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is CUSTOM BENEFIT PROGRAMS INC. Coverage is written through DELTA DENTAL OF VIRGINIA and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 54-1190771 · plan 544 · plan year 2024, filed Sep 8, 2025
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1,326 other employer plans in Virginia 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 8 insured contracts covering health, dental, vision, life and disability; the largest, with DELTA DENTAL OF VIRGINIA, covers 18,422 people.
Reported premium across the insured contracts is $20,803,163, with $1,059,967 in disclosed broker commissions — about 5.1% 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.
CUSTOM BENEFIT PROGRAMS INC is the broker of record on 1 of the 8 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including DELTA DENTAL OF VIRGINIA, LIFE INSURANCE COMPANY OF NORTH AMERICA, AETNA LIFE INSURANCE COMPANY and NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK. DELTA DENTAL OF VIRGINIA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health | 8,406 | Jan 1, 2025 | $2,815,348 | $495,966 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 9,257 | Jan 1, 2025 | $4,651,600 | $232,580 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 8,043 | Jan 1, 2025 | $3,386,634 | $169,332 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life | 12,220 | Jan 1, 2025 | $3,018,975 | $150,949 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life | 12,220 | Jan 1, 2025 | $219,885 | $10,994 |
| NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | Disability | 5 | Jan 1, 2025 | $1,464 | $146 |
| DELTA DENTAL OF VIRGINIA | Dental | 18,422 | Jan 1, 2025 | $5,924,328 | $0 |
| AETNA LIFE INSURANCE COMPANY | Vision | 14,513 | Jan 1, 2025 | $784,929 | $0 |
Premium and claims on this contract
DELTA DENTAL OF VIRGINIA, contract 00000006025. For the contract year on this filing, the carrier reported $5,924,328 in premium earned and $4,709,212 in claims incurred. Dividing one by the other gives 79%.
- DELTA DENTAL OF VIRGINIA, contract 00000006025 reported $764,239 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.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Other plans filed by this employer
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Renewal calendar
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