Form 5500 · Employee benefit plan · SUNBURY, OH
HITACHI ASTEMO AMERICAS, INC.
The filing calls this plan HITACHI ASTEMO AMERICAS, INC. ASSOCIATES HEALTH & WELFARE BENEFIT PLAN.
HITACHI ASTEMO AMERICAS, INC. of SUNBURY, OH insures vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is BENEFIT INSURANCE MARKETING, INC.. Coverage is written through HARTFORD LIFE AND ACCIDENT and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 61-1065272 · plan 501 · plan year 2023, filed Oct 15, 2024
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Life: HARTFORD LIFE AND ACCIDENT covers 31 of 630 participants (4.9%) on Schedule A.
Disability: HARTFORD LIFE AND ACCIDENT covers 31 of 630 participants (4.9%) on Schedule A.
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
Also declared: death benefits, other welfare.
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 3 insured contracts covering vision, life and disability.
The filing declares vision, life, disability, health and dental. Health and dental appear with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium is $1,031,722; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
BENEFIT INSURANCE MARKETING, INC. is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 31 | Jan 1, 2024 | $945,238 | $0 |
| VISION SERVICE PLAN | Vision | 584 | Jan 1, 2024 | $72,539 | $0 |
| UNITED BEHAVIORAL HEALTH DBA OPTUM | — | 647 | Jan 1, 2024 | $13,945 | $0 |
Premium and claims on this contract
VISION SERVICE PLAN, contract 30022558. For the contract year on this filing, the carrier reported $72,539 in premium earned and $65,477 in claims incurred. Dividing one by the other gives 90%.
- VISION SERVICE PLAN, contract 30022558 reported $7,062 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
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 2,482 employees, 29 recordable cases, 111 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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