Form 5500 · Employee benefit plan · HARRISBURG, PA
CJ PONY PARTS, INC.
The filing calls this plan CJ PONY PARTS, INC. HEALTH AND WELFARE.
Public Form 5500 records show how CJ PONY PARTS, INC. of HARRISBURG, PA, a retail employer, structures its employee benefits. Its broker of record is AIA AMERICAN INS. ADMNSTRS. LLC. Coverage is written through DELTA DENTAL OF PENNSYLVANIA and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 25-1735065 · plan 501 · plan year 2025, filed Jun 24, 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
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 4 insured contracts covering dental, vision, life and disability; the largest, with DELTA DENTAL OF PENNSYLVANIA, covers 156 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $82,532, with $9,262 in disclosed broker commissions — about 11% 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.
AIA AMERICAN INS. ADMNSTRS. LLC is the broker of record on 3 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| DELTA DENTAL OF PENNSYLVANIA | Dental | 156 | Jan 1, 2026 | $46,523 | $4,652 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 60 | Jan 1, 2026 | $16,250 | $2,438 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 83 | Jan 1, 2026 | $10,761 | $1,614 |
| HIGHMARK INC. | Vision | 134 | Jan 1, 2026 | $8,998 | $558 |
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.
Reported to OSHA
Reported to OSHA for 2025: 183 employees, 12 recordable cases, 85 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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