Form 5500 · Employee benefit plan · MCCOOK, NE
COMMUNITY HOSPITAL ASSOCIATION
Public Form 5500 records show how COMMUNITY HOSPITAL ASSOCIATION of MCCOOK, NE, a health care and social assistance employer, structures its employee benefits. Its broker of record is TIMOTHY H OLSON. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-0533373 · plan 508 · as of Aug 2026
Plan brief
Schedule A lists 6 insured contracts covering vision, life, disability and stop-loss; the largest, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 253 people.
The only insured piece of the health benefit is stop-loss coverage — the plan itself is self-funded, so premium and commission here reflect the stop-loss contract, not medical premium.
Reported premium across the insured contracts is $2,228,156, with $39,049 in disclosed broker commissions — about 1.8% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
TIMOTHY H OLSON is the broker of record on 2 of the 6 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 344 | December | $382,502 | $30,600 |
| AMERITAS LIFE INSURANCE CORP. | Vision | 221 | December | $65,873 | $6,587 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 146 | December | $20,977 | $1,678 |
| METROPOLITAN LIFE INSURANCE COMPANY | — | 125 | December | $30,955 | $132 |
| METROPOLITAN LIFE INSURANCE COMPANY | — | 249 | December | $39,545 | $52 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Stop-loss | 253 | December | $1,688,304 | $0 |
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