Form 5500 · Employee benefit plan · PLYMOUTH, MN
LEGACY RESTORATION, LLC
The filing calls this plan MULLINS ENTERPRISES LLC DBA LEGACY RESTORATION LLC HEALTH AND WELFARE BENEFIT VISION PLAN.
LEGACY RESTORATION, LLC of PLYMOUTH, MN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is RJF. Coverage is written through EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO.. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-2433040 · plan 503 · 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, vision, through EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO., covering 262 people.
Reported premium across the insured contracts is $16,649, with $1,431 in disclosed broker commissions — about 8.6% 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 |
|---|---|---|---|---|---|
| EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | Vision | 262 | Apr 1, 2024 | $16,649 | $1,431 |
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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