Form 5500 · Employee benefit plan · JASPER, IN
LITTLE COMPANY OF MARY HOSPITAL OF INDIANA, INC. D/B/A MEMORIAL
The filing calls this plan MEMORIAL HOSPITAL & HEALTH CARE CENTER EMPLOYEE BENEFIT PLAN.
LITTLE COMPANY OF MARY HOSPITAL OF INDIANA, INC. D/B/A MEMORIAL of JASPER, IN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is HYLANT GROUP INC.. Coverage is written through PARAMOUNT DENTAL and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-0985964 · plan 510 · plan year 2024, filed May 14, 2025
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
1,291 other employer plans in Indiana have policy years ending in December. 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
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
Also declared: death benefits, 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 5 insured contracts covering dental, vision, life and disability; the largest, with PARAMOUNT DENTAL, covers 2,442 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, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $2,011,523, with $149,543 in disclosed broker commissions — about 7.4% 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.
HYLANT GROUP INC. is the broker of record on 3 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PARAMOUNT DENTAL | Dental | 2,442 | Dec 24, 2024 | $1,048,067 | $52,403 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 1,155 | Dec 24, 2024 | $467,188 | $42,349 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | Life, Disability | 541 | Dec 24, 2024 | $197,422 | $35,874 |
| VISION SERVICE PLAN | Vision | 968 | Dec 24, 2024 | $250,536 | $11,670 |
| TELADOC HEALTH, INC. | — | 1,046 | Dec 24, 2024 | $48,310 | $7,247 |
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.
Reported to OSHA
Reported to OSHA for 2025: 922 employees, 40 recordable cases, 3 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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Renewal calendar
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