Form 5500 · Employee benefit plan · MINNEAPOLIS, MN
PREMIUM WATERS, INC.
PREMIUM WATERS, INC. of MINNEAPOLIS, MN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MARC A. GROVE. Coverage is written through PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 41-1797514 · plan 502 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | Life | 212 | December | $93,563 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 1,216 | December | $87,514 |
| UNUM INSURANCE COMPANY | — | 565 | December | $83,210 |
| HEALTH ADVOCATE SOLUTIONS, INC. | — | 1,232 | December | $0 |
Questions
Who is PREMIUM WATERS, INC.'s benefits broker?
Per its most recent Form 5500 Schedule A, PREMIUM WATERS, INC.'s broker of record is MARC A. GROVE.
What insurance carrier does PREMIUM WATERS, INC. use?
PREMIUM WATERS, INC.'s benefit plan is written through PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, among 4 disclosed carriers.
When does PREMIUM WATERS, INC.'s group plan renew?
The most recent Schedule A policy period for PREMIUM WATERS, INC. ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from PREMIUM WATERS, INC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.