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Form 5500 · Employee benefit plan · SULLIVAN, IN

SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN

SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN of SULLIVAN, IN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is USI INSURANCE SERVICES INC. Coverage is written through SUN LIFE ASSURANCE COMPANY OF CANADA and 3 other carriers. The plan's most recent policy period ended in October.

Benefits broker of record
Plan renews
October

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-1164250 · plan 501 · as of Jul 2026

Participants
0
Carriers on file
4
Disclosed commissions
$115,601
Renewal month
October

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsCommission
SUN LIFE ASSURANCE COMPANY OF CANADAStop-lossOctober$91,944
AMERICAN UNITED LIFELife, Disability362January$13,205
HEALTH RESOURCES INCDental536December$7,136
ANTHEM INSURANCEVisionDecember$3,316

Questions

Who is SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN's benefits broker?

Per its most recent Form 5500 Schedule A, SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN's broker of record is USI INSURANCE SERVICES INC.

What insurance carrier does SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN use?

SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN's benefit plan is written through SUN LIFE ASSURANCE COMPANY OF CANADA, among 4 disclosed carriers.

When does SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN's group plan renew?

The most recent Schedule A policy period for SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN ended in October. Group plans typically renew on the same annual cycle.

Where does this data come from?

All figures are drawn from SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.