Form 5500 · Employee benefit plan · LOUDON, TN
DEL CONCA USA, INC.
The filing calls this plan DEL CONCA USA, INC. EMPLOYEE BENEFITS PLAN.
DEL CONCA USA, INC. of LOUDON, TN insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is JENNIFER LAWRENCE-KINLE. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC. and 3 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 75-3158072 · plan 501 · plan year 2025, filed Nov 21, 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
Also declared: death benefits, 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.
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, dental, vision, life and disability; the largest, with BLUECROSS BLUESHIELD OF TENNESSEE, INC., covers 164 people.
Reported premium across the insured contracts is $736,021, with $53,498 in disclosed broker commissions — about 7.3% of premium.
The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
JENNIFER LAWRENCE-KINLE is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BLUECROSS BLUESHIELD OF TENNESSEE, INC., DELTA DENTAL OF TENNESSEE, THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA and BENEPOWER. BLUECROSS BLUESHIELD OF TENNESSEE, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. | Health, Vision | 164 | Jul 1, 2025 | $613,388 | $36,194 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 113 | Jul 1, 2025 | $56,967 | $13,364 |
| DELTA DENTAL OF TENNESSEE | Dental | 178 | Jul 1, 2025 | $65,666 | $3,940 |
| BENEPOWER | — | — | Jul 1, 2025 | — | $0 |
Premium and claims on this contract
DELTA DENTAL OF TENNESSEE, contract 8554. For the contract year on this filing, the carrier reported $65,666 in premium earned and $43,953 in claims incurred. Dividing one by the other gives 67%.
- DELTA DENTAL OF TENNESSEE, contract 8554 reported $13,133 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Other plans filed by this employer
How this plan compares
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