Form 5500 · Employee benefit plan · GOLDEN VALLEY, MN
GUARDIAN HOSPICE MN, LLC
The filing calls this plan MOMENTS HOSPICE EMPLOYEE BENEFIT PLAN.
GUARDIAN HOSPICE MN, LLC of GOLDEN VALLEY, MN is a 398-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is HOWARD B. LABOW. Coverage is written through AMERICAN HERITAGE LIFE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 81-3526434 · plan 501 · plan year 2025, filed Dec 18, 2025
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23 other employer plans in Minnesota have policy years ending in July. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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: death benefits.
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 4 insured contracts covering dental, vision, life and disability; the largest, with AMERICAN HERITAGE LIFE INSURANCE COMPANY, covers 188 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $626,891, with $138,007 in disclosed broker commissions — about 22% of premium.
The most recent policy period ended in July, and the plan year ends July 31. Group contracts typically renew on that annual cycle.
HOWARD B. LABOW is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | Life, Disability | 188 | Aug 1, 2025 | $233,974 | $97,816 |
| DELTA DENTAL OF MINNESOTA | Dental | 534 | Aug 1, 2025 | $208,447 | $21,979 |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 438 | Aug 1, 2025 | $145,658 | $10,061 |
| AMERITAS LIFE INSURANCE CORP. | Vision | 519 | Aug 1, 2025 | $38,812 | $8,151 |
Premium and claims on this contract
DELTA DENTAL OF MINNESOTA, contract 251827. For the contract year on this filing, the carrier reported $208,447 in premium earned and $111,837 in claims incurred. Dividing one by the other gives 54%.
- DELTA DENTAL OF MINNESOTA, contract 251827 reported $52,633 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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Renewal calendar
23 other employer plans in Minnesota are August 1 renewals (policy year ends July).
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