Form 5500 · Employee benefit plan · HOUSTON, TX
LEWIS FOOD TOWN INC
The filing calls this plan LEWIS FOOD TOWN, INC EMPLOYEE BENEFITS PLAN.
LEWIS FOOD TOWN INC of HOUSTON, TX is a 200-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is VARIOUS AGENTS-SEE ATTACHED. Coverage is written through BLUECROSS BLUESHIELD OF TEXAS and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 76-0432940 · plan 501 · plan year 2025, filed Jul 21, 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
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
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.
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; the largest, with BLUECROSS BLUESHIELD OF TEXAS, covers 330 people.
The filing declares health, dental, vision and life. Life appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $1,537,002, with $108,911 in disclosed broker commissions — about 7.1% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
VARIOUS AGENTS-SEE ATTACHED is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | 331 | Jan 1, 2026 | $405,019 | $72,679 |
| BLUECROSS BLUESHIELD OF TEXAS | Health, Dental | 330 | Jan 1, 2026 | $1,105,992 | $33,241 |
| DEARBORN LIFE INSURANCE COMPANY | Vision | 256 | Jan 1, 2026 | $25,991 | $2,991 |
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.
Reported to OSHA
Reported to OSHA for 2025: 2,606 employees, 62 recordable cases, 841 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
One establishment filed under this EIN is left out of these figures: the hours and employees it reported could not both be right.
Other plans filed by this employer
How this plan compares
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