Form 5500 · Employee benefit plan · CAMDEN, ME
DAVIS LONG TERM CARE GROUP, INC.
The filing calls this plan DAVIS LONG TERM CARE GROUP INC WELFARE BENEFITS PLAN.
DAVIS LONG TERM CARE GROUP, INC. of CAMDEN, ME insures health, dental, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is BENECURV. Coverage is written through HARVARD PILGRIM HEALTH CARE and 4 other carriers. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-8047766 · plan 501 · plan year 2024, filed Jan 8, 2025
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5 other employer plans in Maine have policy years ending in August. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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
Also declared: death benefits.
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 5 insured contracts covering health, dental, life and disability; the largest, with HARVARD PILGRIM HEALTH CARE, covers 113 people.
Reported premium across the insured contracts is $1,483,343, with $50,711 in disclosed broker commissions — about 3.4% of premium.
The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.
BENECURV is the broker of record on 2 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including HARVARD PILGRIM HEALTH CARE, HPHC INSURANCE COMPANY, UNUM LIFE INSURANCE COMPANY OF AMERICA and STANDARD INSURANCE COMPANY. HARVARD PILGRIM HEALTH CARE writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARVARD PILGRIM HEALTH CARE | Health | 113 | Sep 1, 2024 | $831,845 | $26,242 |
| HPHC INSURANCE COMPANY | Health | 39 | Sep 1, 2024 | $504,280 | $14,633 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 403 | Sep 1, 2024 | $71,636 | $5,811 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | Life, Disability | 76 | Sep 1, 2024 | $24,103 | $2,228 |
| STANDARD INSURANCE COMPANY | Dental | 138 | Sep 1, 2024 | $51,479 | $1,797 |
Premium and claims on this contract
STANDARD INSURANCE COMPANY, contract 756868. For the contract year on this filing, the carrier reported $51,479 in premium earned and $37,285 in claims incurred. Dividing one by the other gives 72%.
- STANDARD INSURANCE COMPANY, contract 756868 reported $14,916 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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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Renewal calendar
5 other employer plans in Maine are September 1 renewals (policy year ends August).
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