Form 5500 · Employee benefit plan · WINTER PARK, FL
4R RESTAURANT GROUP, LLC
The filing calls this plan 4R RESTAURANT GROUP LLC WELFARE BENEFITS PLAN.
Public Form 5500 records show how 4R RESTAURANT GROUP, LLC of WINTER PARK, FL, a hospitality and food service employer, structures its employee benefits. Its broker of record is FRINGE BENEFIT PLANS INC.. Coverage is written through HEALTH OPTIONS and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 27-2064689 · plan 502 · plan year 2024, filed Jun 20, 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.
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 HEALTH OPTIONS, covers 112 people.
Reported premium across the insured contracts is $1,351,705, with $16,118 in disclosed broker commissions — about 1.2% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
FRINGE BENEFIT PLANS INC. is the broker of record on all 3 contracts.
3 carriers appear on the filing, including HEALTH OPTIONS, BLUE CROSS BLUE SHIELD OF FLORIDA and SUN LIFE ASSURANCE COMPANY OF CANADA. HEALTH OPTIONS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Dental, Vision, Life, Disability | 179 | Jan 1, 2025 | $88,813 | $9,803 |
| HEALTH OPTIONS | Health | 112 | Jan 1, 2025 | $956,363 | $4,782 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 39 | Jan 1, 2025 | $306,529 | $1,533 |
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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