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Form 5500 · Employee benefit plan · HAUPPAUGE, NY

DONALDSON INTERIORS, INC.

The filing calls this plan DONALDSON INTERIORS HEALTH AND WELFARE PLAN.

DONALDSON INTERIORS, INC. of HAUPPAUGE, NY insures health, dental, vision and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is HUB INTERNATIONAL NORTHEAST LIMITED. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in January.

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

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 11-3440666 · plan 501 · plan year 2025, filed Nov 14, 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.

All participants at the start of the year
123
Active at start of year
122
Active at end of year
127
Disclosed commissions
$78,256
Typical renewal
February 1

Benefits declared on this filing

Healthinsured — UNITEDHEALTHCARE INSURANCE COMPANY215 of 123 participants
Dentalinsured — UNITEDHEALTHCARE INSURANCE COMPANY215 of 123 participants
Visioninsured — UNITEDHEALTHCARE INSURANCE COMPANY215 of 123 participants
Lifenot declared on this filing
Disabilityinsured — SUN LIFE AND HEALTH INSURANCE COMPANY102 of 123 participants (83%)

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, dental, vision and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 215 people.

Reported premium across the insured contracts is $1,712,691, with $78,256 in disclosed broker commissions — about 4.6% of premium.

The most recent policy period ended in January, and the plan year ends January 31. Group contracts typically renew on that annual cycle.

HUB INTERNATIONAL NORTHEAST LIMITED is the broker of record on all 2 contracts.

Two carriers split the book: UNITEDHEALTHCARE INSURANCE COMPANY and SUN LIFE AND HEALTH INSURANCE COMPANY.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
UNITEDHEALTHCARE INSURANCE COMPANYHealth, Dental, Vision215Feb 1, 2025$1,659,664$69,698
SUN LIFE AND HEALTH INSURANCE COMPANYDisability102Feb 1, 2025$53,027$8,558

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
DONALDSON INTERIORS, INC.
EIN 11-3440666

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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