Form 5500 · Employee benefit plan · PROVO, UT
QUALTRICS, LLC
QUALTRICS, LLC's employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is GBS BENEFITS INSURANCE AGENCY. Coverage is written through PRUDENTIAL INSURANCE COMPANY OF AMERICA and 5 other carriers. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-4964116 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life | 2,697 | December | $308,855 |
| HARTFORD LIFE AND ACCIDENT | Disability | 2,689 | December | $28,403 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental | 8 | August | $17,245 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Life, Disability | 8 | August | $1,839 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life, Disability | 8 | August | $174 |
| COMPSYCH THE GUIDANCE RESOURCE COMPANY | — | 2,837 | May | $0 |
Questions
Who is QUALTRICS, LLC's benefits broker?
Per its most recent Form 5500 Schedule A, QUALTRICS, LLC's broker of record is GBS BENEFITS INSURANCE AGENCY.
What insurance carrier does QUALTRICS, LLC use?
QUALTRICS, LLC's benefit plan is written through PRUDENTIAL INSURANCE COMPANY OF AMERICA, among 6 disclosed carriers.
When does QUALTRICS, LLC's group plan renew?
The most recent Schedule A policy period for QUALTRICS, LLC ended in August. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from QUALTRICS, LLC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.