Form 5500 · Employee benefit plan · WILMINGTON, DE
SIMON EYE MANAGEMENT
The filing calls this plan SIMON EYE MANAGEMENT WELFARE BENEFIT PLAN.
SIMON EYE MANAGEMENT of WILMINGTON, DE files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is PATRIOT GROWTH INSURANCE SERVICES. Coverage is written through AETNA LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 83-2231457 · plan 501 · plan year 2025, filed Aug 19, 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.
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 health, dental, life and disability; the largest, with AETNA LIFE INSURANCE COMPANY, covers 162 people.
Reported premium across the insured contracts is $1,013,206, with $21,823 in disclosed broker commissions — about 2.2% of premium.
The most recent policy period ended in March, and the plan year ends March 31. Group contracts typically renew on that annual cycle.
PATRIOT GROWTH INSURANCE SERVICES is the broker of record on all 2 contracts.
Two carriers split the book: AETNA LIFE INSURANCE COMPANY and COLONIAL LIFE & ACCIDENT INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Life, Disability | 67 | Apr 1, 2025 | $62,765 | $17,793 |
| AETNA LIFE INSURANCE COMPANY | Health, Dental | 162 | Apr 1, 2025 | $950,441 | $4,030 |
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.
Other plans filed by this employer
How this plan compares
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