Form 5500 · Employee benefit plan · OZARK, MO
HAVEN HOME HEALTH, LLC
The filing calls this plan HAVEN HOME HEALTH, LLC EMPLOYEE BENEFITS PLAN.
HAVEN HOME HEALTH, LLC of OZARK, MO files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is OLLIS AND COMPANY. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-3612130 · plan 501 · plan year 2025, filed Jul 14, 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: 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 10 insured contracts covering health, dental, vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 145 people.
Reported premium across the insured contracts is $609,132, with $23,537 in disclosed broker commissions — about 3.9% 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.
OLLIS AND COMPANY is the broker of record on 3 of the 10 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including UNITEDHEALTHCARE INSURANCE COMPANY, DELTA DENTAL OF MISSOURI, UNITED OF OMAHA LIFE INSURANCE COMPANY and ADVANTICA INSURANCE COMPANY. UNITEDHEALTHCARE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 145 | Jan 1, 2026 | $520,762 | $13,600 |
| DELTA DENTAL OF MISSOURI | Dental | 124 | Jan 1, 2026 | $39,409 | $3,620 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 16 | Jan 1, 2026 | $12,504 | $1,876 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 55 | Jan 1, 2026 | $10,518 | $1,578 |
| ADVANTICA INSURANCE COMPANY | Vision | 114 | Jan 1, 2026 | $8,155 | $746 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 23 | Jan 1, 2026 | $4,850 | $728 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 6 | Jan 1, 2026 | $4,681 | $702 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 18 | Jan 1, 2026 | $3,312 | $497 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 102 | Jan 1, 2026 | $1,268 | $190 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 16 | Jan 1, 2026 | $3,673 | $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.
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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