Form 5500 · Employee benefit plan · COLLINSVILLE, AL
COLLINSVILLE NURSING HOME, INC.
The filing calls this plan COLLINSVILLE NURSING HOME WELFARE BENEFIT PLAN.
COLLINSVILLE NURSING HOME, INC. of COLLINSVILLE, AL is a 183-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is HOLLIFIELD PATRICK. Coverage is written through KC LIFE and 2 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 63-0630902 · plan 502 · plan year 2025, filed Apr 15, 2026
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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
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 4 insured contracts covering health, dental, vision, life and disability; the largest, with KC LIFE, covers 192 people.
Reported premium across the insured contracts is $164,986, with $21,195 in disclosed broker commissions — about 13% of premium.
The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
HOLLIFIELD PATRICK is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including KC LIFE, METROPOLITAN LIFE INSURANCE COMPANY and NATIONAL GUARDIAN LIFE INSURANCE COMPANY. KC LIFE writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KC LIFE | Dental, Life | 192 | Jul 1, 2025 | $87,841 | $9,798 |
| METROPOLITAN LIFE INSURANCE COMPANY | Life, Disability | 50 | Jul 1, 2025 | $43,950 | $6,505 |
| METROPOLITAN LIFE INSURANCE COMPANY | Health | 42 | Jul 1, 2025 | $15,424 | $3,085 |
| NATIONAL GUARDIAN LIFE INSURANCE COMPANY | Vision | 324 | Jul 1, 2025 | $17,771 | $1,807 |
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. 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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