Form 5500 · Employee benefit plan · MT. POCONO, PA
MOUNT AIRY #1, LLC
MOUNT AIRY #1, LLC of MT. POCONO, PA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is UNIVERSAL EMPLOYEE BENEFIT SOLUTION. Coverage is written through UNITED OF OMAHA LIFE INSURANCE COMPANY and 10 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-1454362 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 218 | July | $11,261 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 202 | July | $3,841 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 202 | July | $3,783 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 629 | July | $2,294 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 22 | July | $433 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 22 | July | $308 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental | 420 | July | $0 |
| FAIR AMERICAN INSURANCE AND REINSURANCE COMPANY | Stop-loss | 377 | July | $0 |
| EVEREST REINSURANCE COMPANY | Stop-loss | 0 | July | $0 |
| NATIONAL VISION ADMINISTRATORS, LLC | Vision | 0 | July | $0 |
| REVIVEHEALTH | Vision | 0 | July | $0 |
Questions
Who is MOUNT AIRY #1, LLC's benefits broker?
Per its most recent Form 5500 Schedule A, MOUNT AIRY #1, LLC's broker of record is UNIVERSAL EMPLOYEE BENEFIT SOLUTION.
What insurance carrier does MOUNT AIRY #1, LLC use?
MOUNT AIRY #1, LLC's benefit plan is written through UNITED OF OMAHA LIFE INSURANCE COMPANY, among 11 disclosed carriers.
When does MOUNT AIRY #1, LLC's group plan renew?
The most recent Schedule A policy period for MOUNT AIRY #1, LLC ended in July. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from MOUNT AIRY #1, LLC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.