Form 5500 · Employee benefit plan · MONTCLAIR, CA
GIANT INLAND EMPIRE RV CENTER, INC.
The filing calls this plan GIANT RV WELFARE BENEFITS PLAN.
GIANT INLAND EMPIRE RV CENTER, INC. of MONTCLAIR, CA spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is ACRISURE OF CALIFORNIA LLC. Coverage is written through HEALTH NET and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-4079692 · plan 501 · plan year 2025, filed Aug 7, 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
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
Schedule A lists 4 insured contracts covering health, dental, vision and life; the largest, with HEALTH NET, covers 82 people.
Reported premium across the insured contracts is $1,073,199, with $53,249 in disclosed broker commissions — about 5% 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.
ACRISURE OF CALIFORNIA LLC is the broker of record on all 4 contracts.
4 carriers appear on the filing, including HEALTH NET, THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, THE LINCOLN NATIONAL LIFE INSURANCE COMPANY and VISION PLAN OF AMERICA. HEALTH NET writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HEALTH NET | Health | 82 | Jan 1, 2026 | $1,002,852 | $48,835 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental | 76 | Jan 1, 2026 | $48,999 | $2,779 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 205 | Jan 1, 2026 | $11,916 | $880 |
| VISION PLAN OF AMERICA | Vision | 70 | Jan 1, 2026 | $9,432 | $755 |
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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