Form 5500 · Employee benefit plan · GROVE CITY, PA
GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA
The filing calls this plan GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA FBP.
Public Form 5500 records show how GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA of GROVE CITY, PA, a health care and social assistance employer, structures its employee benefits. Its broker of record is HUB INTERNATIONAL NORTHEAST LIMITED. Coverage is written through PRINCIPAL LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 25-0753320 · plan 501 · plan year 2025, filed Sep 21, 2026
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2,778 other employer plans in Pennsylvania have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Self-funded as reported
The filing names a third-party administrator on Schedule A and reports no medical premium.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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.
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 12 insured contracts covering health, dental, vision, life and disability; the largest, with PRINCIPAL LIFE INSURANCE COMPANY, covers 467 people.
Reported premium across the insured contracts is $395,209, with $34,013 in disclosed broker commissions — about 8.6% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
HUB INTERNATIONAL NORTHEAST LIMITED is the broker of record on 10 of the 12 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including PRINCIPAL LIFE INSURANCE COMPANY, PRUDENTIAL INSURANCE COMPANY OF AMERICA and VISION BENEFITS OF AMERICA. PRINCIPAL LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 128 | Jan 1, 2026 | $40,613 | $8,577 |
| PRINCIPAL LIFE INSURANCE COMPANY | Health, Dental | 467 | Jan 1, 2026 | $142,030 | $5,570 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 44 | Jan 1, 2026 | $5,357 | $4,464 |
| VISION BENEFITS OF AMERICA | Vision | 259 | Jan 1, 2026 | $15,573 | $2,336 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | 111 | Jan 1, 2026 | $49,632 | $2,232 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Disability | 95 | Jan 1, 2026 | $10,577 | $2,116 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Disability | 91 | Jan 1, 2026 | $10,105 | $2,021 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 375 | Jan 1, 2026 | $56,618 | $1,786 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Disability | 375 | Jan 1, 2026 | $35,183 | $1,786 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life, Disability | 375 | Jan 1, 2026 | $8,088 | $1,786 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Health | 57 | Jan 1, 2026 | $20,563 | $1,339 |
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 38 | Jan 1, 2026 | $870 | — |
Premium and claims on this contract
VISION BENEFITS OF AMERICA, contract 7501. For the contract year on this filing, the carrier reported $15,573 in premium earned and $19,076 in claims incurred. Dividing one by the other gives 122%.
- VISION BENEFITS OF AMERICA, contract 7501 reported $-3,504 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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
Named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 286 employees, 11 recordable cases, 20 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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