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Form 5500 · Employee benefit plan · LOGANSPORT, IN

CITY OF LOGANSPORT

The filing calls this plan CITY OF LOGANSPORT BENEFIT PLAN.

CITY OF LOGANSPORT of LOGANSPORT, IN is a 123-participant public administration employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is HENRIOTT GROUP INC. Coverage is written through HIGHMARK LIFE & CASUALTY GROUP and 2 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-6001093 · plan 501 · plan year 2024, filed Aug 18, 2025

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How this plan is funded

Self-funded as reported

The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.

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.

All participants at the start of the year
123
Active at start of year
123
Active at end of year
119
Disclosed commissions
$0
Typical renewal
January 1

Benefits declared on this filing

Healthdeclared, no contract here says it covers this
Dentaldeclared, no contract here says it covers this
Visioninsured — VISION SERVICE PLAN124 of 123 participants
Lifedeclared, no contract here says it covers this
Disabilitydeclared, no contract here says it covers this

One contract on this filing does not say which benefits it covers, so a line above may be insured by it.

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.

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 vision and stop-loss; the largest, with HIGHMARK LIFE & CASUALTY GROUP, covers 120 people.

The filing declares vision, health, dental, life and disability. Health, dental, life and disability appear with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.

The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The stop-loss contract reports $669,799 in premium and $0 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.

Reported premium is $762,947; 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.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
HIGHMARK LIFE & CASUALTY GROUPStop-loss120Jan 2, 2025$669,799$0
DELTA DENTAL OF INDIANA—325Jan 1, 2025$93,148$0
VISION SERVICE PLANVision124Jan 1, 2025—$0

Premium and claims on this contract

DELTA DENTAL OF INDIANA, contract 0000950. For the contract year on this filing, the carrier reported $93,148 in premium earned and $84,653 in claims incurred. Dividing one by the other gives 91%.

  • DELTA DENTAL OF INDIANA, contract 0000950 reported $7,012 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.

See the filing at the Department of Labor

Administrator and service providers

OPTUM RX INC
Claims processing · EIN 33-0441200
$371,593
paid directly by the plan
USI INSURANCE SERVICES LLC
BROKER · EIN 13-3771734
$11,629
paid directly by the plan
HENRIOTT GROUP INC.
BROKER · EIN 35-1494527
$33,263
paid directly by the plan
UMR INC.
Claims processing · EIN 39-1995276
$127,948
paid directly by the plan

Named on Schedule C of this filing. We publish company names only.

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