Form 5500 · Employee benefit plan · BLUE BELL, PA
EVERGREEN SENIOR MANAGEMENT
The filing calls this plan EVERGREEN SENIOR MANAGEMENT WELFARE BENEFIT PLAN.
EVERGREEN SENIOR MANAGEMENT of BLUE BELL, PA is a 1,183-participant administrative and support services employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is CORPORATE SYNERGIES, LLC. Coverage is written through INDEPENDENCE BLUE CROSS and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 46-3140763 · plan 502 · plan year 2025, filed Aug 7, 2026
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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, 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 7 insured contracts covering health, dental, vision, life and disability; the largest, with INDEPENDENCE BLUE CROSS, covers 631 people.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
CORPORATE SYNERGIES, LLC is the broker of record on 1 of the 7 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including INDEPENDENCE BLUE CROSS, LIFE INSURANCE COMPANY OF NORTH AMERICA, UNITED CONCORDIA INSURANCE COMPANY and HEARTLAND. INDEPENDENCE BLUE CROSS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life, Disability | 1,084 | Jan 1, 2026 | $310,444 | $25,222 |
| RELIASTAR LIFE INSURANCE COMPANY | — | 168 | Jan 1, 2026 | $38,142 | $8,887 |
| UNITED CONCORDIA INSURANCE COMPANY | Dental | 856 | Jan 1, 2026 | $237,087 | $0 |
| HEARTLAND | Vision | 961 | Jan 1, 2026 | $58,334 | $0 |
| INTEGRATED BEHAVIORAL HEALTH | — | 1,850 | Jan 1, 2026 | $55,610 | $0 |
| INDEPENDENCE BLUE CROSS | Health | 450 | Jan 1, 2026 | $981,537 | $-4,249 |
| INDEPENDENCE BLUE CROSS | Health | 631 | Jan 1, 2026 | $5,237,517 | $-30,102 |
Premium and claims on these contracts
UNITED CONCORDIA INSURANCE COMPANY, contract 900925-000. For the contract year on this filing, the carrier reported $237,087 in premium earned and $142,159 in claims incurred. Dividing one by the other gives 60%.
INDEPENDENCE BLUE CROSS, contract 0002363445. For the contract year on this filing, the carrier reported $981,537 in premium earned and $1,297,520 in claims incurred. Dividing one by the other gives 132%.
INDEPENDENCE BLUE CROSS, contract 0002363445. For the contract year on this filing, the carrier reported $5,237,517 in premium earned and $3,259,151 in claims incurred. Dividing one by the other gives 62%.
- UNITED CONCORDIA INSURANCE COMPANY, contract 900925-000 reported $81,203 in retention.
- INDEPENDENCE BLUE CROSS, contract 0002363445 reported $43,067 in retention.
- INDEPENDENCE BLUE CROSS, contract 0002363445 reported $515,325 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.
Reported to OSHA
Reported to OSHA for 2025: 334 employees, 10 recordable cases, 57 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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