Form 5500 · Employee benefit plan · CLINTON, MO
GOLDEN VALLEY MEMORIAL HEALTHCARE
Public Form 5500 records show how GOLDEN VALLEY MEMORIAL HEALTHCARE of CLINTON, MO, a health care and social assistance employer, structures its employee benefits. Its broker of record is FRIENDSHIP INSURANCE SERVICES LLC. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 43-0975390 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 3 insured contracts covering life, disability and stop-loss; the largest, with SUN LIFE ASSURANCE COMPANY OF CANADA, covers 681 people.
The only insured piece of the health benefit is stop-loss coverage — the plan itself is self-funded, so premium and commission here reflect the stop-loss contract, not medical premium.
Reported premium across the insured contracts is $1,986,818, with $7,127 in disclosed broker commissions — about 0.4% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
FRIENDSHIP INSURANCE SERVICES LLC is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | — | 98 | December | $26,567 | $7,127 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 827 | December | $339,562 | $0 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Stop-loss | 681 | December | $1,620,689 | $0 |
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