Form 5500 · Employee benefit plan · CUMBERLAND, WI
CUMBERLAND HEALTHCARE
The filing calls this plan CUMBERLAND MEMORIAL HOSPITAL, INC. LIFE INSURANCE PLAN.
CUMBERLAND HEALTHCARE of CUMBERLAND, WI files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is NOAH INSURANCE GROUP INC. Coverage is written through METROPOLITAN LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-0831153 · plan 507 · plan year 2025, filed May 12, 2026
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How this plan is funded
Self-funded as reported
The filing names a third-party administrator on Schedule A and reports no medical premium.
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: death benefits, 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.
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 3 insured contracts covering dental, vision, life and disability; the largest, with METROPOLITAN LIFE INSURANCE COMPANY, covers 372 people.
Reported premium across the insured contracts is $371,400, with $33,715 in disclosed broker commissions — about 9.1% 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.
NOAH INSURANCE GROUP INC is the broker of record on all 3 contracts.
Two carriers split the book: METROPOLITAN LIFE INSURANCE COMPANY and UNITED OF OMAHA LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| METROPOLITAN LIFE INSURANCE COMPANY | Dental, Vision, Life, Disability | 372 | Jan 1, 2026 | $204,212 | $16,996 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Dental | 134 | Jan 1, 2026 | $147,920 | $14,792 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Vision | 108 | Jan 1, 2026 | $19,268 | $1,927 |
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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