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Form 5500 · Employee benefit plan · PACOIMA, CA

FORMA BRANDS, LLC

FORMA BRANDS, LLC of PACOIMA, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MERCER HEALTH AND BENEFITS, LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 8 other carriers. The plan's most recent policy period ended in February.

Benefits broker of record
Plan renews
February

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 92-2190793 · plan 501 · as of Jul 2026

Participants
161
Carriers on file
9
Disclosed commissions
$118,297
Renewal month
February

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsCommission
CIGNA HEALTH AND LIFE INSURANCE COMPANYHealth103February$51,330
METROPOLITAN LIFE INSURANCE COMPANYDental, Vision, Life, Disability286February$32,299
KAISER FOUNDATION HEALTH PLAN INCHealth73February$16,820
KAISER FOUNDATION HEALTH PLAN INCHealth23February$8,932
METROPOLITAN LIFE INSURANCE COMPANY29February$4,314
METROPOLITAN LIFE INSURANCE COMPANY40February$4,071
SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATIONDental45February$463
SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATIONDental6February$64
SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATIONDental0February$4

Questions

Who is FORMA BRANDS, LLC's benefits broker?

Per its most recent Form 5500 Schedule A, FORMA BRANDS, LLC's broker of record is MERCER HEALTH AND BENEFITS, LLC.

What insurance carrier does FORMA BRANDS, LLC use?

FORMA BRANDS, LLC's benefit plan is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY, among 9 disclosed carriers.

When does FORMA BRANDS, LLC's group plan renew?

The most recent Schedule A policy period for FORMA BRANDS, LLC ended in February. Group plans typically renew on the same annual cycle.

Where does this data come from?

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