Form 5500 · Employee benefit plan · ITHACA, NY
ITHACA COLLEGE
The filing calls this plan EMERITI RETIREE HEALTH PLAN FOR ITHACA COLLEGE.
ITHACA COLLEGE of ITHACA, NY is a 1,349-participant education employer — a large group whose insured benefits are disclosed on Schedule A of its Form 5500. Coverage is written through AETNA LIFE INSURANCE COMPANY. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 15-0532204 · plan 504 · plan year 2024, filed Oct 9, 2025
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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.
Benefits declared on this filing
Health: AETNA LIFE INSURANCE COMPANY covers 64 of 1,349 participants (4.7%) on Schedule A.
Dental: AETNA LIFE INSURANCE COMPANY covers 45 of 1,349 participants (3.3%) on Schedule A.
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
Schedule A lists 2 insured contracts covering health and dental.
Reported premium is $128,740; 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.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY | Health | 64 | Jan 1, 2025 | $101,571 | $0 |
| AETNA LIFE INSURANCE COMPANY | Dental | 45 | Jan 1, 2025 | $27,169 | $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
Named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
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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