Form 5500 · Employee benefit plan · TERRE HAUTE, IN
UNION HOSPITAL INC
The filing calls this plan UNION HOSPITAL, INC. SHORT TERM DISABILITY PLAN.
Public Form 5500 records show how UNION HOSPITAL INC of TERRE HAUTE, IN, a health care and social assistance employer, structures its employee benefits. Its broker of record is NATIONAL BENEFITS CENTER. Coverage is written through SYMETRA LIFE INSURANCE COMPANY. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-0876396 · plan 509 · plan year 2025, filed Jul 9, 2026
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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 1 insured contract covering life and disability; the largest, with SYMETRA LIFE INSURANCE COMPANY, covers 1,468 people.
Reported premium is $1,090,421; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SYMETRA LIFE INSURANCE COMPANY | Life, Disability | 1,468 | Jan 1, 2026 | $1,090,421 | $0 |
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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