Form 5500 · Employee benefit plan · LOGAN, UT
JACK'S TIRE AND OIL MANAGEMENT COMP
The filing calls this plan JACK'S TIRE AND OIL WELFARE PLAN.
JACK'S TIRE AND OIL MANAGEMENT COMP of LOGAN, UT is a 235-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is GBS BENEFITS INC.. Coverage is written through BIND BENEFITS, INC. DBA SUREST and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 87-0503267 · plan 501 · plan year 2023, filed Jul 29, 2024
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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: 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.
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 4 insured contracts covering health, dental, vision, life and disability; the largest, with BIND BENEFITS, INC. DBA SUREST, covers 224 people.
Reported premium across the insured contracts is $1,806,202, with $31,269 in disclosed broker commissions — about 1.7% 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.
GBS BENEFITS INC. is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BIND BENEFITS, INC. DBA SUREST, UNITEDHEALTHCARE INSURANCE COMPANY, EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA and UNITED OF OMAHA LIFE INSURANCE COMPANY. BIND BENEFITS, INC. DBA SUREST writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 323 | Jan 1, 2024 | $111,070 | $14,753 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Health, Disability | 222 | Jan 1, 2024 | $49,723 | $9,945 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Health, Dental, Vision | 444 | Jan 1, 2024 | $680,647 | $6,571 |
| BIND BENEFITS, INC. DBA SUREST | Health | 224 | Jan 1, 2024 | $964,762 | $0 |
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.
Other plans filed by this employer
How this plan compares
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