Form 5500 · Employee benefit plan · PORTLAND, ME
CLARK INSURANCE
The filing calls this plan GROUP LONG TERM CARE.
CLARK INSURANCE of PORTLAND, ME files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is CLARK INSURANCE. Coverage is written through UNUM LIFE INSURANCE COMPANY OF AMERICA. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 01-0046400 · plan 502 · plan year 2024, filed May 14, 2025
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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
Also declared: other welfare.
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
Reported premium across the insured contracts is $25,324, with $3,799 in disclosed broker commissions — about 15% of premium.
The most recent policy period ended in November, and the plan year ends November 30. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | — | 77 | Dec 1, 2024 | $25,324 | $3,799 |
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.
Other plans filed by this employer
How this plan compares
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