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Form 5500 · Employee benefit plan · CONCORD, NY

MATERA HEALTH LLC

The filing calls this plan MATERA HEALTH AND WELFARE.

MATERA HEALTH LLC of CONCORD, NY insures health, dental and vision coverage for its employees, per Schedule A of its Form 5500. Its broker of record is HUB INTERNATIONAL NORTHEAST. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in August.

Benefits broker of record
Policy year ends
Augustas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 88-3371041 · plan 501 · plan year 2024, filed Jan 31, 2025

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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.

All participants at the start of the year
110
Active at start of year
110
Active at end of year
120
Disclosed commissions
$81,318
Typical renewal
September 1

Benefits declared on this filing

Healthinsured — CIGNA HEALTH AND LIFE INSURANCE COMPANY154 of 110 participants
Dentalinsured — UNITEDHEALTHCARE INSURANCE COMPANY227 of 110 participants
Visioninsured — UNITEDHEALTHCARE INSURANCE COMPANY227 of 110 participants
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

Schedule A lists 2 insured contracts covering health, dental and vision; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 154 people.

Reported premium across the insured contracts is $410,048, with $81,318 in disclosed broker commissions — about 20% of premium.

The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.

HUB INTERNATIONAL NORTHEAST is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.

Two carriers split the book: CIGNA HEALTH AND LIFE INSURANCE COMPANY and UNITEDHEALTHCARE INSURANCE COMPANY.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
CIGNA HEALTH AND LIFE INSURANCE COMPANYHealth154Sep 1, 2024$344,781$72,780
UNITEDHEALTHCARE INSURANCE COMPANYDental, Vision227Sep 1, 2024$65,267$8,538

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
MATERA HEALTH LLC
EIN 88-3371041

The plan administrator is from line 3a of the main form. We publish company names only.

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