Form 5500 · Employee benefit plan · NEWPORT, VT
NORTH COUNTRY HOSPITAL
NORTH COUNTRY HOSPITAL of NEWPORT, VT spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is ACADIA BENEFITS INC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 03-0185556 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 4 insured contracts covering vision, life, disability and stop-loss; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 806 people.
The only insured piece of the health benefit is stop-loss coverage — the plan itself is self-funded, so premium and commission here reflect the stop-loss contract, not medical premium.
Reported premium across the insured contracts is $1,464,456, with $46,687 in disclosed broker commissions — about 3.2% 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.
ACADIA BENEFITS INC is the broker of record on all 4 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Stop-loss | 806 | December | $1,024,779 | $27,764 |
| RELIASTAR LIFE INSURANCE COMPANY | Life | 510 | December | $104,890 | $10,192 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Disability | 469 | December | $260,139 | $6,601 |
| VISION SERVICE PLAN | Vision | 331 | December | $74,648 | $2,130 |
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