Form 5500 · Employee benefit plan · NORTHUMBERLAND, PA
LEEDS HEALTH CARE SERVICES, INC., DBA NOTTINGHAM VILLAGE
The filing calls this plan LEEDS HEALTH CARE SERVICES, INC. , DBA NOTTINGHAM VILLAGE HEALTH AND WELFARE BENEFIT PLAN.
Public Form 5500 records show how LEEDS HEALTH CARE SERVICES, INC., DBA NOTTINGHAM VILLAGE of NORTHUMBERLAND, PA, a health care and social assistance employer, structures its employee benefits. Its broker of record is AP BENEFIT ADVISORS LLC. Coverage is written through STANDARD INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-0378052 · plan 503 · plan year 2026, filed Jun 29, 2026
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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: 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.
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, dental, vision, life and disability; the largest, with STANDARD INSURANCE COMPANY, covers 202 people.
Reported premium across the insured contracts is $108,709, with $14,681 in disclosed broker commissions — about 14% of premium.
The most recent policy period ended in January, and the plan year ends January 31. Group contracts typically renew on that annual cycle.
AP BENEFIT ADVISORS LLC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: STANDARD INSURANCE COMPANY and SUN LIFE ASSURANCE COMPANY OF CANADA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| STANDARD INSURANCE COMPANY | Health, Life, Disability | 202 | Feb 1, 2026 | $65,073 | $10,314 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Dental, Vision | 101 | Feb 1, 2026 | $43,636 | $4,367 |
Premium and claims on this contract
STANDARD INSURANCE COMPANY, contract 169955. For the contract year on this filing, the carrier reported $50,899 in premium earned and $12,099 in claims incurred. Dividing one by the other gives 24%.
- STANDARD INSURANCE COMPANY, contract 169955 reported $32,299 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. The service providers are named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 265 employees, 9 recordable cases, 4 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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