Form 5500 · Employee benefit plan · NEW ALBANY, MS
KEVIN CHARLES FINE UPHOLSTERY FURNITURE
The filing calls this plan KEVIN CHARLES FINE UPHOLSTERY FURNITURE EMPLOYEE BENEFITS PLAN.
KEVIN CHARLES FINE UPHOLSTERY FURNITURE of NEW ALBANY, MS is a 97-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is CADENCE INSURANCE INC. Coverage is written through BLUE CROSS & BLUE SHIELD OF MISSISSIPPI, A MUTUAL INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 02-0635323 · plan 502 · plan year 2025, filed Oct 10, 2025
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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.
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, life and disability; the largest, with BLUE CROSS & BLUE SHIELD OF MISSISSIPPI, A MUTUAL INSURANCE COMPANY, covers 98 people.
Reported premium across the insured contracts is $508,501, with $26,149 in disclosed broker commissions — about 5.1% of premium.
The most recent policy period ended in March, and the plan year ends March 31. Group contracts typically renew on that annual cycle.
CADENCE INSURANCE INC is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: BLUE CROSS & BLUE SHIELD OF MISSISSIPPI, A MUTUAL INSURANCE COMPANY and SUN LIFE ASSURANCE COMPANY OF CANADA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANADA | Dental, Vision, Life, Disability | 95 | Apr 1, 2025 | $106,987 | $14,471 |
| BLUE CROSS & BLUE SHIELD OF MISSISSIPPI, A MUTUAL INSURANCE COMPANY | Health | 98 | Apr 1, 2025 | $401,514 | $11,678 |
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.
Reported to OSHA
Reported to OSHA for 2025: 98 employees, 6 recordable cases, 132 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
How this plan compares
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