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Form 5500 · Employee benefit plan · SOUTH PLAINFIELD, NJ

A. J. JERSEY, INC

The filing calls this plan A. J. JERSEY, INC. HEALTH AND WELFARE BENEFIT PLAN.

A. J. JERSEY, INC of SOUTH PLAINFIELD, NJ is a 169-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is CBIZ BENEFITS & INSURANCE SERVICE. Coverage is written through HORIZON HEALTHCARE SERVICES, INC. and 5 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
CBIZ BENEFITS & INSURANCE SERVICE
Insurance carrier
HORIZON HEALTHCARE SERVICES, INC.
Policy year ends
Decemberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 22-1905554 · plan 501 · plan year 2025, filed Jul 1, 2026

Get an email when this employer files a new Form 5500, and again about four months before its plan renews.

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.

All participants at the start of the year
169
Active at start of year
169
Active at end of year
163
Disclosed commissions
$90,321
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — HORIZON HEALTHCARE SERVICES, INC.113 of 169 participants (67%)
Dentalinsured — DELTA DENTAL OF NEW JERSEY, INC.228 of 169 participants
Visioninsured — HORIZON INSURANCE COMPANY124 of 169 participants (73%)
Lifeinsured — UNITED OF OMAHA LIFE INSURANCE COMPANY93 of 169 participants (55%) on the largest contract
Disabilityinsured — THE LINCOLN NATIONAL LIFE INSURANCE COMPANY16 of 169 participants (9.5%) on the largest contract

Disability: the largest of the 2 insured disability contracts, with THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, covers 16 of 169 participants (9.5%) on Schedule A.

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 7 insured contracts covering health, dental, vision, life and disability; the largest, with HORIZON HEALTHCARE SERVICES, INC., covers 113 people.

Reported premium across the insured contracts is $2,306,313, with $90,321 in disclosed broker commissions — about 3.9% 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.

CBIZ BENEFITS & INSURANCE SERVICE is the broker of record on 3 of the 7 contracts; the rest name a different broker or none.

6 carriers appear on the filing, including HORIZON HEALTHCARE SERVICES, INC., UNITED OF OMAHA LIFE INSURANCE COMPANY, THE LINCOLN NATIONAL LIFE INSURANCE COMPANY and DELTA DENTAL OF NEW JERSEY, INC.. HORIZON HEALTHCARE SERVICES, INC. writes the largest contract by premium.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
HORIZON HEALTHCARE SERVICES, INC.Health113Jan 1, 2026$2,218,236$75,420
UNITED OF OMAHA LIFE INSURANCE COMPANYLife93Jan 1, 2026$30,083$4,513
DELTA DENTAL OF NEW JERSEY, INC.Dental228Jan 1, 2026$11,034$3,921
THE LINCOLN NATIONAL LIFE INSURANCE COMPANYDisability16Jan 1, 2026$25,505$3,826
UNITED OF OMAHA LIFE INSURANCE COMPANYLife163Jan 1, 2026$10,015$1,502
HORIZON INSURANCE COMPANYVision124Jan 1, 2026$11,034$1,103
PRINCIPAL LIFE INSURANCE COMPANYDisability2Jan 1, 2026$406$36

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
A. J. JERSEY, INC
EIN 22-1905554

The plan administrator is from line 3a of the main form. We publish company names only.

Other plans filed by this employer

. Medical PlanInsured benefit plan · 1 Schedule A contractRenews ~Jan 1. Dental PlanInsured benefit plan · 1 Schedule A contractRenews ~Jan 1. Life Insurance PlanInsured benefit plan · 2 Schedule A contractsRenews ~Jan 1. Vision PlanInsured benefit plan · 1 Schedule A contractRenews ~Jan 1Employees Profit Sharing 401(K) PlanRetirement plan · 1 Schedule A contract

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