Form 5500 · Employee benefit plan · POMONA, CA
LEE JENNINGS TARGET EXPRESS, INC.
The filing calls this plan LEE JENNINGS TARGET EXPRESS, INC EMPLOYEE BENEFIT PLAN.
Public Form 5500 records show how LEE JENNINGS TARGET EXPRESS, INC. of POMONA, CA, a transportation and logistics employer, structures its employee benefits. Its broker of record is ACRISURE SOUTHWEST PARTNERS INSURAN. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 1 other carrier. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 33-0170655 · plan 501 · plan year 2025, filed Jul 13, 2026
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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 3 insured contracts covering health, dental, vision and life; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 126 people.
Reported premium across the insured contracts is $1,391,424, with $51,698 in disclosed broker commissions — about 3.7% 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.
ACRISURE SOUTHWEST PARTNERS INSURAN is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
Two carriers split the book: KAISER FOUNDATION HEALTH PLAN, INC. and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 126 | Oct 1, 2025 | $891,180 | $32,703 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 38 | Oct 1, 2025 | $408,394 | $10,976 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, Life | 106 | Oct 1, 2025 | $91,850 | $8,019 |
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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