Form 5500 · Employee benefit plan · LAS VEGAS, NV
FOLIOT FURNITURE PACIFIC INC.
The filing calls this plan FOLIOT FURNITURE HEALTH PLAN.
FOLIOT FURNITURE PACIFIC INC. of LAS VEGAS, NV is a 102-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is CBIZ BENEFITS & INS SERVICES INC. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 42-1769776 · plan 501 · plan year 2024, filed Jun 26, 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
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, health, through UNITEDHEALTHCARE INSURANCE COMPANY, covering 210 people.
Reported premium across the insured contracts is $915,390, with $44,262 in disclosed broker commissions — about 4.8% 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.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 210 | Dec 1, 2024 | $915,390 | $44,262 |
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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