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Form 5500 · Employee benefit plan · NOBLESVILLE, IN

BREAKERS UNLIMITED INC

The filing calls this plan BREAKERS UNLIMITED INC HEALTH AND WELFARE BENEFIT PLAN.

BREAKERS UNLIMITED INC of NOBLESVILLE, IN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ASSUREDPARTNERS. Coverage is written through ANTHEM INSURANCE COMPANIES, INC. and 1 other carrier. 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 35-1801594 · plan 501 · plan year 2025, filed Jun 22, 2026

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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.

All participants at the start of the year
103
Active at start of year
103
Active at end of year
104
Disclosed commissions
$37,349
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — ANTHEM INSURANCE COMPANIES, INC.162 of 103 participants
Dentaldeclared under plan 502
Visioninsured — ANTHEM INSURANCE COMPANIES, INC.162 of 103 participants
Lifeinsured — ANTHEM LIFE INSURANCE COMPANY104 of 103 participants
Disabilitydeclared under plan 503

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.

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 2 insured contracts covering health, vision and life; the largest, with ANTHEM INSURANCE COMPANIES, INC., covers 162 people.

Reported premium across the insured contracts is $1,302,549, with $37,349 in disclosed broker commissions — about 2.9% 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.

ASSUREDPARTNERS is the broker of record on all 2 contracts.

Two carriers split the book: ANTHEM INSURANCE COMPANIES, INC. and ANTHEM LIFE INSURANCE COMPANY.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
ANTHEM INSURANCE COMPANIES, INC.Health, Vision162Jan 1, 2026$1,296,937$36,882
ANTHEM LIFE INSURANCE COMPANYLife104Jan 1, 2026$5,612$467

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
BREAKERS UNLIMITED INC
EIN 35-1801594

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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