Form 5500 · Employee benefit plan · FORT WAYNE, IN
EAR, NOSE & THROAT ASSOCIATES, P.C.
The filing calls this plan EAR, NOSE & THROAT ASSOCIATES, P.C. BENEFIT PLAN.
EAR, NOSE & THROAT ASSOCIATES, P.C. of FORT WAYNE, IN is a 124-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is PHILLIPS BENEFITS ADVISORS, LLC. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 1 other carrier. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-1086214 · plan 501 · plan year 2025, filed Jan 19, 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
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 3 insured contracts covering dental, vision, life and disability; the largest, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 116 people.
Reported premium across the insured contracts is $203,775, with $31,618 in disclosed broker commissions — about 16% 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.
PHILLIPS BENEFITS ADVISORS, LLC is the broker of record on all 3 contracts.
Two carriers split the book: SUN LIFE ASSURANCE COMPANY OF CANADA and DELTA DENTAL OF INDIANA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life, Disability | 116 | Jul 1, 2025 | $149,528 | $26,150 |
| DELTA DENTAL OF INDIANA | Dental | 144 | Jul 1, 2025 | $46,164 | $4,657 |
| DELTA DENTAL OF INDIANA | Vision | 134 | Jul 1, 2025 | $8,083 | $811 |
Premium and claims on these contracts
DELTA DENTAL OF INDIANA, contract 10380. For the contract year on this filing, the carrier reported $45,984 in premium earned and $44,073 in claims incurred. Dividing one by the other gives 96%.
DELTA DENTAL OF INDIANA, contract V10380. For the contract year on this filing, the carrier reported $8,041 in premium earned and $7,797 in claims incurred. Dividing one by the other gives 97%.
- DELTA DENTAL OF INDIANA, contract 10380 reported $7,734 in retention.
- DELTA DENTAL OF INDIANA, contract V10380 reported $2,447 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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