Form 5500 · Employee benefit plan · CHICAGO, IL
LUSTER PRODUCTS, INC.
The filing calls this plan HEALTH PLAN FOR HOURLY AND SALARIED EMPLOYEES OF LUSTER PRODUCTS, INC.
Public Form 5500 records show how LUSTER PRODUCTS, INC. of CHICAGO, IL, a manufacturing employer, structures its employee benefits. Its broker of record is DIGITAL INSURANCE INC.. Coverage is written through BLUECROSS BLUESHIELD OF ILLINOIS and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 36-2447832 · plan 501 · plan year 2023, filed Jun 3, 2024
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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.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
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 4 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with BLUECROSS BLUESHIELD OF ILLINOIS, covers 137 people.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $1,128,376, with $28,659 in disclosed broker commissions — about 2.5% 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.
DIGITAL INSURANCE INC. is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS | Health, Stop-loss | 137 | Jan 1, 2024 | $989,672 | $14,304 |
| STANDARD INSURANCE COMPANY | Life, Disability | 119 | Jan 1, 2024 | $81,243 | $10,976 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental | 103 | Jan 1, 2024 | $48,190 | $2,375 |
| EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | Vision | 292 | Jan 1, 2024 | $9,271 | $1,004 |
Premium and claims on these contracts
BLUECROSS BLUESHIELD OF ILLINOIS, contract 343107. For the contract year on this filing, the carrier reported $989,672 in premium earned and $973,334 in claims incurred. Dividing one by the other gives 98%.
STANDARD INSURANCE COMPANY, contract 166873. For the contract year on this filing, the carrier reported $81,243 in premium earned and $24,331 in claims incurred. Dividing one by the other gives 30%.
- BLUECROSS BLUESHIELD OF ILLINOIS, contract 343107 reported $16,339 in retention.
- STANDARD INSURANCE COMPANY, contract 166873 reported $56,910 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.
Reported to OSHA
Reported to OSHA for 2025: 108 employees, 1 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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