Form 5500 · Employee benefit plan · PLYMOUTH, MN
LEGACY RESTORATION, LLC
The filing calls this plan MULLINS ENTRPRISES LLC DBA LEGACY RESTORATION LLC DENTAL PLAN.
LEGACY RESTORATION, LLC of PLYMOUTH, MN is a 145-participant construction employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is MARSH AND MCLENNAN AGENCY. Coverage is written through DELTA DENTAL OF MINNESOTA. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-2433040 · plan 502 · plan year 2024, filed Jan 9, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
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, dental, through DELTA DENTAL OF MINNESOTA, covering 332 people.
Reported premium across the insured contracts is $148,354, with $11,304 in disclosed broker commissions — about 7.6% 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.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| DELTA DENTAL OF MINNESOTA | Dental | 332 | Apr 1, 2024 | $148,354 | $11,304 |
Premium and claims on this contract
DELTA DENTAL OF MINNESOTA, contract 102796. For the contract year on this filing, the carrier reported $138,351 in premium earned and $75,683 in claims incurred. Dividing one by the other gives 55%.
- DELTA DENTAL OF MINNESOTA, contract 102796 reported $34,934 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.
Other plans filed by this employer
How this plan compares
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