form5500lookup

Form 5500 · Employee benefit plan · ISSAQUAH, WA

EVERGREEN RESTAURANT GROUP, LLC

EVERGREEN RESTAURANT GROUP, LLC's employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is USI INSURANCE SERVICES LLC. Coverage is written through USABLE LIFE and 1 other carrier. The plan's most recent policy period ended in January.

Benefits broker of record
Insurance carrier
Plan renews
January

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 91-1663379 · plan 502 · as of Jul 2026

Participants
165
Carriers on file
2
Disclosed commissions
$10,157
Renewal month
January

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsCommission
USABLE LIFELife, Disability147January$8,727
WILLAMETTE DENTAL OF WASHINGTON, INC.Dental64January$1,430

Questions

Who is EVERGREEN RESTAURANT GROUP, LLC's benefits broker?

Per its most recent Form 5500 Schedule A, EVERGREEN RESTAURANT GROUP, LLC's broker of record is USI INSURANCE SERVICES LLC.

What insurance carrier does EVERGREEN RESTAURANT GROUP, LLC use?

EVERGREEN RESTAURANT GROUP, LLC's benefit plan is written through USABLE LIFE, among 2 disclosed carriers.

When does EVERGREEN RESTAURANT GROUP, LLC's group plan renew?

The most recent Schedule A policy period for EVERGREEN RESTAURANT GROUP, LLC ended in January. Group plans typically renew on the same annual cycle.

Where does this data come from?

All figures are drawn from EVERGREEN RESTAURANT GROUP, LLC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.