Form 5500 · Employee benefit plan · STAMFORD, CT
CITIGROUP INC.
The filing calls this plan CITIGROUP DENTAL BENEFIT PLAN.
CITIGROUP INC. of STAMFORD, CT files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MERCER HEALTH & BENEFITS LLC. Coverage is written through METROPOLITAN LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 52-1568099 · plan 505 · plan year 2024, filed Oct 10, 2025
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How this plan is funded
Self-funded as reported
The filing reports benefits paid from the plan's own money, and no medical insurance contract on Schedule A.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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 3 insured contracts covering health and dental; the largest, with METROPOLITAN LIFE INSURANCE COMPANY, covers 82,330 people.
Reported premium is $59,932,423; the filing discloses no broker commission on these contracts.
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 LLC is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
Two carriers split the book: METROPOLITAN LIFE INSURANCE COMPANY and CIGNA HEALTH AND LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY | Dental | 82,330 | Jan 1, 2025 | $51,881,596 | $0 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental | 20,677 | Jan 1, 2025 | $6,860,366 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | Dental | 2,570 | Jan 1, 2025 | $1,190,461 | $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. The service providers are named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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