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Form 5500 · Employee benefit plan · MEMPHIS, TN

PENN A KEM LLC

The filing calls this plan PENN A KEM LIFE & DISABILITY PLAN.

PENN A KEM LLC of MEMPHIS, TN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is HUB INTERNATIONAL MIDWEST LIMITED. Coverage is written through UNUM LIFE INSURANCE COMPANY OF AMERICA. The plan's most recent policy period ended in December.

Benefits broker of record
Policy year ends
Decemberas filed for plan year 2023

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 26-2770135 · plan 502 · plan year 2023, filed Oct 4, 2024

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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.

All participants at the start of the year
160
Active at start of year
160
Active at end of year
0
Disclosed commissions
$38,199
Typical renewal
January 1

Benefits declared on this filing

Healthdeclared under plan 515
Dentaldeclared under plan 515
Visiondeclared under plan 515
Lifeinsured — UNUM LIFE INSURANCE COMPANY OF AMERICA175 of 160 participants
Disabilityinsured — UNUM LIFE INSURANCE COMPANY OF AMERICA175 of 160 participants

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 1 insured contract covering life and disability; the largest, with UNUM LIFE INSURANCE COMPANY OF AMERICA, covers 175 people.

Reported premium across the insured contracts is $235,075, with $38,199 in disclosed broker commissions — about 16% 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.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
UNUM LIFE INSURANCE COMPANY OF AMERICALife, Disability175Jan 1, 2024$235,075$38,199

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
PENN A KEM LLC
EIN 26-2770135

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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