Form 5500 · Employee benefit plan · COLUMBIA, PA
KLEEN-RITE CORPORATION
The filing calls this plan KLEEN-RITE MEDICAL.
KLEEN-RITE CORPORATION of COLUMBIA, PA is a 114-participant wholesale trade employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is AMERICAN INSURANCE ADMINISTRATORS. Coverage is written through CAPITAL ADVANTAGE ASSURANCE COMPANY. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 23-1712065 · plan 502 · plan year 2025, filed Mar 4, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
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
The filing discloses a single insured line, health, through CAPITAL ADVANTAGE ASSURANCE COMPANY, covering 130 people.
Reported premium across the insured contracts is $779,434, with $38,346 in disclosed broker commissions — about 4.9% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CAPITAL ADVANTAGE ASSURANCE COMPANY | Health | 130 | Oct 1, 2025 | $779,434 | $38,346 |
Premium and claims on this contract
CAPITAL ADVANTAGE ASSURANCE COMPANY, contract 704930. For the contract year on this filing, the carrier reported $779,434 in premium earned and $850,129 in claims incurred. Dividing one by the other gives 109%.
- CAPITAL ADVANTAGE ASSURANCE COMPANY, contract 704930 reported $58,711 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: 130 employees, 4 recordable cases, 17 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
Subscribers see how this compares with similar plans in Pennsylvania. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in Pennsylvania — largest plans, brokers, carriers and renewal months.