Form 5500 · Employee benefit plan · VINCENNES, IN
PACE COMMUNITY ACTION AGENCY, INC.
The filing calls this plan PACE COMMUNITY ACTION AGENCY.
PACE COMMUNITY ACTION AGENCY, INC. of VINCENNES, IN is a 87-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is GERMAN AMERICAN INSURANCE INC. Coverage is written through ANTHEM LIFE INSURANCE COMPANY. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-1120537 · plan 501 · plan year 2025, filed Oct 31, 2025
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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
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 life and disability; the largest, with ANTHEM LIFE INSURANCE COMPANY, covers 93 people.
Reported premium across the insured contracts is $36,123, with $2,590 in disclosed broker commissions — about 7.2% of premium.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
GERMAN AMERICAN INSURANCE INC is the broker of record on all 2 contracts.
At 87 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ANTHEM LIFE INSURANCE COMPANY | Disability | 93 | May 1, 2025 | $29,180 | $2,074 |
| ANTHEM LIFE INSURANCE COMPANY | Life | 93 | May 1, 2025 | $6,943 | $516 |
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.
Other plans filed by this employer
How this plan compares
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