form5500lookup

Form 5500 · Employee benefit plan · CHICAGO, IL

EXELON CORPORATION

The filing calls this plan PECO ENERGY COMPANY RETIREE MEDICAL PLAN.

EXELON CORPORATION of CHICAGO, IL spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Coverage is written through KEYSTONE 65 HMO and 2 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
Not disclosed
Insurance carrier
Policy year ends
Decemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 23-2990190 · plan 516 · plan year 2024, filed Oct 20, 2025

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How this plan is funded

Both, as reported

The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.

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.

All participants at the start of the year
1,685
Carriers on file
3
Disclosed commissions
$0
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — KEYSTONE 65 HMO271 of 1,685 participants (16%) on the largest contract
Dentalinsured — CIGNA HEALTH AND LIFE INSURANCE COMPANY25 of 1,685 participants (1.5%)
Visiondeclared under plan 504
Lifedeclared under plan 509
Disabilitydeclared under plan 512

Dental: CIGNA HEALTH AND LIFE INSURANCE COMPANY covers 25 of 1,685 participants (1.5%) on Schedule A.

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 health and dental.

Reported premium is $1,940,540; the filing discloses no broker commission on these contracts.

The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.

No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.

3 carriers appear on the filing, including KEYSTONE 65 HMO, QCC INSURANCE COMPANY and CIGNA HEALTH AND LIFE INSURANCE COMPANY. KEYSTONE 65 HMO writes the largest contract by premium.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
KEYSTONE 65 HMOHealth271Jan 1, 2025$1,645,300$0
QCC INSURANCE COMPANYHealth38Jan 1, 2025$281,542$0
CIGNA HEALTH AND LIFE INSURANCE COMPANYHealth, Dental25Jan 1, 2025$13,698$0

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
EXELON CORPORATION
EIN 23-2990190
INDEPENDENCE HOSPITAL INDEMNITY PLN
Contract administrator · EIN 23-0370270
$715,459
paid directly by the plan
OPTUMRX
Contract administrator · EIN 11-2581812
$420,940
paid directly by the plan
ALIGHT SOLUTIONS LLC
Recordkeeping and information management · EIN 82-1061233
$279,160
paid directly by the plan
EXELON BUSINESS SERVICES COMPANY
Plan administrator · EIN 23-3063219
$91,336
paid directly by the plan
WILLIS TOWERS WATSON US LLC
ACTUARY · EIN 53-0181291
$61,685
paid directly by the plan
KEYSTONE HEALTH PLAN EAST
Contract administrator · EIN 23-2405376
$43,311
paid directly by the plan
CIGNA HEALTH AND LIFE INSURANCE CO
Contract administrator · EIN 59-1031071
$43,243
paid directly by the plan
HEALTH CARE SERVICE CORP.
Contract administrator · EIN 36-1236610
$42,280
paid directly by the plan
QCC INSURANCE COMPANY
Contract administrator · EIN 23-2184623
$28,747
paid directly by the plan
EDGEWOOD PARTNERS INSURANCE CENTER
CONSULTING · EIN 94-3195221
$14,638
paid directly by the plan

The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.

Money the plan held and paid out

Plan assets at year end
$149,145,896
Paid out in benefits
$24,489,348
Paid to insurance carriersSchedule H, line 2e(2)
$1,938,584
Accountant's opinion (Schedule H, line 3a)
Unmodified
Audit fee
$26,570

Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H

These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.

Other plans filed by this employer

How this plan compares

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