Form 5500 · Employee benefit plan · COLLINSVILLE, AL
COLLINSVILLE NURSING HOME, INC.
The filing calls this plan COLLINSVILLE NURSING HOME GROUP HEALTH CARE PLAN.
Public Form 5500 records show how COLLINSVILLE NURSING HOME, INC. of COLLINSVILLE, AL, a health care and social assistance employer, structures its employee benefits. Its broker of record is UTIC INSURANCE COMPANY. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 63-0630902 · plan 501 · plan year 2025, filed Dec 31, 2025
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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
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
The filing discloses a single insured line, health, through SUN LIFE ASSURANCE COMPANY OF CANADA, covering 129 people.
Reported premium across the insured contracts is $498,153, with $158,209 in disclosed broker commissions — about 32% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Health | 129 | Jun 1, 2025 | $498,153 | $158,209 |
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.
Reported to OSHA
Reported to OSHA for 2025: 270 employees, 15 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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