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Form 5500 · Employee benefit plan · GREENSBORO, NC

BATTLEGROUND RESTAURANT GROUP INC

The filing calls this plan BATTLEGROUND RESTAURANT GROUP HEALTH & DENTAL PLAN.

BATTLEGROUND RESTAURANT GROUP INC of GREENSBORO, NC insures health, vision, life, disability and stop-loss coverage for its employees, per Schedule A of its Form 5500. Its broker of record is ACS BENEFIT SERVICES LLC. Coverage is written through COMPANION LIFE INSURANCE COMPANY DBA IISI and 3 other carriers. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 56-1800894 · plan 501 · plan year 2025, filed Sep 10, 2026

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How this plan is funded

Self-funded as reported

The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.

A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.

All participants at the start of the year
184
Active at start of year
184
Active at end of year
200
Disclosed commissions
$24,679
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — COMPANION LIFE INSURANCE COMPANY DBA IISI200 of 184 participants
Dentalnot declared on this filing
Visioninsured — STARMOUNT LIFE INSURANCE COMPANY157 of 184 participants (85%)
Lifeinsured — RELIANCE STANDARD LIFE INSURANCE COMPANY104 of 184 participants (57%) on the largest contract
Disabilityinsured — RELIANCE STANDARD LIFE INSURANCE COMPANY104 of 184 participants (57%)

Also declared: other welfare.

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 4 insured contracts covering health, vision, life, disability and stop-loss; the largest, with COMPANION LIFE INSURANCE COMPANY DBA IISI, covers 200 people.

The medical plan carries stop-loss coverage: the filing reports the plan paying its own health claims, with insured protection against large ones.

Reported premium across the insured contracts is $241,649, with $24,679 in disclosed broker commissions — about 10% of premium.

The health contract's policy period ended in December, while at least one ancillary line's policy period ended in November. The plan is on a split renewal cycle.

ACS BENEFIT SERVICES LLC is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
COMPANION LIFE INSURANCE COMPANY DBA IISIHealth, Stop-loss200Jan 1, 2026$149,128$14,922
RELIANCE STANDARD LIFE INSURANCE COMPANYLife, Disability104Dec 1, 2025$74,617$7,461
STARMOUNT LIFE INSURANCE COMPANYVision157Feb 1, 2026$14,160$1,699
USABLE LIFELife195Jan 1, 2026$3,744$597

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
BATTLEGROUND RESTAURANT GROUP INC
EIN 56-1800894
ACS BENEFIT SERVICES, LLC
Claims processing · Contract administrator · EIN 56-1472467
$76,661
paid directly by the plan
LEGACY INSURANCE PARTNERS
CONSULTANT · EIN 84-3748559
$60,000
paid directly by the plan
VOLTAIRE HEALTH, LLC DBA PAYER COMP
OTHER · EIN 46-2047081
$30,831
paid directly by the plan
AMERICAN HEALTH HOLDING, INC.
INSURANCE SERVICES · EIN 31-1368946
$8,030
paid directly by the plan

The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.

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