Form 5500 · Employee benefit plan · BEACHWOOD, OH
RETINA ASSOCIATES OF CLEVELAND, INC.
The filing calls this plan RETINA ASSOCIATES OF CLEVELAND, INC., EMPLOYEE BENEFITS PLAN.
RETINA ASSOCIATES OF CLEVELAND, INC. of BEACHWOOD, OH is a 168-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is ONEDIGITAL EXPRESSLINK LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 34-1411937 · plan 504 · plan year 2025, filed Jul 31, 2026
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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.
Benefits declared on this filing
Also declared: death benefits.
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 3 insured contracts covering health, dental, vision, life and disability; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 256 people.
Reported premium across the insured contracts is $994,003, with $20,415 in disclosed broker commissions — about 2.1% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in April. The plan is on a split renewal cycle.
ONEDIGITAL EXPRESSLINK LLC is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including CIGNA HEALTH AND LIFE INSURANCE COMPANY, HARTFORD LIFE AND ACCIDENT and SUN LIFE ASSURANCE COMPANY OF CANADA. CIGNA HEALTH AND LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 185 | Jan 1, 2026 | $126,166 | $13,017 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental, Vision | 256 | Jan 1, 2026 | $862,418 | $6,779 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life | 65 | May 1, 2025 | $5,419 | $619 |
Premium and claims on this contract
CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 636173. For the contract year on this filing, the carrier reported $862,418 in premium earned and $791,783 in claims incurred. Dividing one by the other gives 92%.
- CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 636173 reported $24,512 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. We publish company names only.
Other plans filed by this employer
How this plan compares
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