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Form 5500 · Employee benefit plan · INDIANAPOLIS, IN

INDIANA HISTORICAL SOCIETY, INC.

The filing calls this plan THE HEALTH AND WELFARE BENEFIT PLAN OF INDIANA HISTORICAL SOCIETY, INC.

INDIANA HISTORICAL SOCIETY, INC. of INDIANAPOLIS, IN is a 48-participant arts, entertainment and recreation employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through EVEREST REINSURANCE COMPANY. The plan's most recent policy period ended in December.

Benefits broker of record
Not disclosed
Policy year ends
Decemberas filed for plan year 2023

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-0876384 · plan 501 · plan year 2023, filed Jul 8, 2024

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How this plan is funded

Self-funded as reported

The filing reports benefits paid from the plan's own money, and no medical insurance contract on Schedule A.

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
48
Active at start of year
47
Active at end of year
46
Disclosed commissions
$0
Typical renewal
January 1

Benefits declared on this filing

Healthdeclared, not on Schedule A
Dentalnot declared on this filing
Visionnot declared on this filing
Lifenot declared on this filing
Disabilitynot declared on this filing

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.

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

The filing discloses a single insured line, stop-loss, through EVEREST REINSURANCE COMPANY, covering 46 people.

The filing declares 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.

The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The premium and commission here are for the stop-loss contract, not for medical premium.

Reported premium is $232,165; 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.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
EVEREST REINSURANCE COMPANYStop-loss46Jan 1, 2024$232,165$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
INDIANA HISTORICAL SOCIETY, INC.
EIN 35-0876384
GALLAGHER BENEFITS SERVICES (BH PRE
BROKER · EIN 36-4291971
$19,982
paid directly by the plan
CONNECTCARE3
PATIENT ADVOCATE · EIN 26-1768616
$3,060
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.

Reported to OSHA

Reported to OSHA for 2025: 105 employees, 1 recordable cases, 0 days away from work.

EmployeesThe company's own average for the year
105
Hours worked
146,580
Recordable cases
1
Days away from work
0

Source: OSHA Injury Tracking Application establishment data, 2025.

Money the plan held and paid out

Plan assets at year end
$81,615
Paid out in benefits
$530,991

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

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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