Form 5500 · Employee benefit plan · SHERMAN OAKS, CA
GALAXY THEATRES LLC
The filing calls this plan GALAXY THEATRES LLC HEALTH & WELFARE BENEFIT PLAN.
Public Form 5500 records show how GALAXY THEATRES LLC of SHERMAN OAKS, CA, a information and media employer, structures its employee benefits. Its broker of record is PONTRELLI TIMOUR & ASSOCIATES INC.. Coverage is written through BLUE CROSS OF CALIFORNIA and 1 other carrier. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-4680444 · plan 501 · plan year 2025, filed Sep 4, 2026
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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
Also declared: death benefits.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 life; the largest, with BLUE CROSS OF CALIFORNIA, covers 134 people.
Reported premium across the insured contracts is $1,100,375, with $52,709 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.
PONTRELLI TIMOUR & ASSOCIATES INC. is the broker of record on all 2 contracts.
Two carriers split the book: BLUE CROSS OF CALIFORNIA and PRINCIPAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS OF CALIFORNIA | Health | 134 | Dec 1, 2025 | $990,713 | $45,573 |
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental, Vision, Life | 170 | Dec 1, 2025 | $109,662 | $7,136 |
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.
Other plans filed by this employer
How this plan compares
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