Form 5500 · Employee benefit plan · PEACH GLEN, PA
KNOUSE FOODS COOPERATIVE INC
The filing calls this plan HOSPITALIZATION PLAN FACTORY EMPLOYEES.
KNOUSE FOODS COOPERATIVE INC of PEACH GLEN, PA is a 5-participant manufacturing employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through CAPITAL ADVANTAGE ASSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 23-1324775 · plan 503 · plan year 2024, filed May 27, 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
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 health, dental and vision.
Reported premium is $8,425; the filing discloses no broker commission on these contracts.
The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
3 carriers appear on the filing, including CAPITAL ADVANTAGE ASSURANCE COMPANY, UNITED CONCORDIA INSURANCE COMPANY and METROPOLITAN LIFE INSURANCE COMPANY. CAPITAL ADVANTAGE ASSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CAPITAL ADVANTAGE ASSURANCE COMPANY | Health | 0 | Nov 1, 2024 | $8,145 | $0 |
| UNITED CONCORDIA INSURANCE COMPANY | Dental | 0 | Nov 1, 2024 | $241 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY | Vision | 0 | Nov 1, 2024 | $39 | $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.
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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