Form 5500 · Employee benefit plan · MT. WASHINGTON, KY
FORTNA SYSTEMS, INC.
The filing calls this plan FORTNA SYSTEMS, INC. HEALTH & WELFARE PLAN.
FORTNA SYSTEMS, INC. of MT. WASHINGTON, KY is a 1,817-participant professional services employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Its broker of record is MERCER HEALTH AND BENEFITS, LLC. Coverage is written through DELTA DENTAL OF KENTUCKY and 4 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 61-1350369 · plan 501 · plan year 2025, filed Jun 17, 2026
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58 other employer plans in Kentucky have policy years ending in May. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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.
Benefits declared on this filing
Health: FOUR EVER LIFE INS CO. covers 6 of 1,817 participants (0.3%) on Schedule A.
Also declared: prepaid legal, 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 12 insured contracts covering health, dental, vision, life and disability; the largest, with DELTA DENTAL OF KENTUCKY, covers 3,106 people.
Reported premium across the insured contracts is $3,415,222, with $392,004 in disclosed broker commissions — about 11% of premium.
The health contract's policy period ended in May, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
MERCER HEALTH AND BENEFITS, LLC is the broker of record on 7 of the 12 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including DELTA DENTAL OF KENTUCKY, RELIANCE STANDARD LIFE INSURANCE COMPANY, FIDELITY SECURITY LIFE INSURANCE COMPANY and FOUR EVER LIFE INS CO.. DELTA DENTAL OF KENTUCKY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| DELTA DENTAL OF KENTUCKY | Dental | 3,106 | Jan 1, 2026 | $964,024 | $81,942 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 1,948 | Jan 1, 2026 | $440,808 | $66,121 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 1,769 | Jan 1, 2026 | $657,483 | $65,748 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 550 | Jan 1, 2026 | $432,810 | $64,922 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | — | 673 | Jan 1, 2026 | $136,547 | $27,309 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | — | 656 | Jan 1, 2026 | $126,875 | $25,375 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 2,444 | Jan 1, 2026 | $227,431 | $22,781 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | — | 323 | Jan 1, 2026 | $64,639 | $12,928 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 1,811 | Jan 1, 2026 | $232,749 | $9,310 |
| ARAG INSURANCE COMPANY | — | 448 | Jan 1, 2026 | $62,963 | $8,884 |
| FOUR EVER LIFE INS CO. | Health | 6 | Jun 1, 2025 | $65,403 | $6,540 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 36 | Jan 1, 2026 | $3,490 | $144 |
Premium and claims on this contract
DELTA DENTAL OF KENTUCKY, contract 0708890. For the contract year on this filing, the carrier reported $931,242 in premium earned and $761,446 in claims incurred. Dividing one by the other gives 82%.
- DELTA DENTAL OF KENTUCKY, contract 0708890 reported $237,460 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: 991 employees, 8 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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Renewal calendar
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