Form 5500 · Employee benefit plan · LAS VEGAS, NV
FOLIOT FURNITURE PACIFIC INC.
The filing calls this plan FOLIOT FURNITURE DENTAL PLAN.
FOLIOT FURNITURE PACIFIC INC. of LAS VEGAS, NV is a small manufacturing employer whose insured group plan is on public record in its Form 5500 filing. Its broker of record is CBIZ BENEFITS & INSURANCE SERVICES. Coverage is written through PREMIER ACCESS INSURANCE COMPANY. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 42-1769776 · plan 502 · plan year 2024, filed Jun 26, 2025
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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
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
The filing discloses a single insured line, dental, through PREMIER ACCESS INSURANCE COMPANY, covering 195 people.
Reported premium across the insured contracts is $35,593, with $2,133 in disclosed broker commissions — about 6% of premium.
The most recent policy period ended in November, and the plan year ends November 30. Group contracts typically renew on that annual cycle.
At 98 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PREMIER ACCESS INSURANCE COMPANY | Dental | 195 | Dec 1, 2024 | $35,593 | $2,133 |
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: 185 employees, 3 recordable cases, 1 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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