Form 5500 · Employee benefit plan · CARMICHAELS, PA
COMMUNITY BANK
The filing calls this plan COMMUNITY BANK HEALTH PROTECTION PLAN.
COMMUNITY BANK of CARMICHAELS, PA is a 164-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is LR WEBBER ASSOCIATES. Coverage is written through UNIMERICA INSURANCE COMPANY and 4 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 25-0393033 · plan 501 · plan year 2025, filed Jun 24, 2026
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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.
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
Schedule A lists 5 insured contracts covering dental, vision, life, disability and stop-loss.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The 2 stop-loss contracts report $408,316 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 across the insured contracts is $681,887, with $25,587 in disclosed broker commissions — about 3.8% 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 |
|---|---|---|---|---|---|
| AMERICAN UNITED LIFE INSURANCE COMPANY | Life, Disability | 167 | Dec 1, 2025 | $185,938 | $18,049 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Dental | 142 | Dec 1, 2025 | $70,148 | $7,015 |
| HIGHMARK INC. | Vision | 143 | Dec 1, 2025 | $17,485 | $523 |
| UNIMERICA INSURANCE COMPANY | Stop-loss | 0 | Oct 1, 2025 | $336,527 | $0 |
| THE NORTH RIVER INSURANCE COMPANY | Stop-loss | 136 | Dec 1, 2025 | $71,789 | $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. We publish company names only.
Other plans filed by this employer
How this plan compares
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