Form 5500 · Employee benefit plan · LEHI, UT
SAFE STREETS USA LLC
Public Form 5500 records show how SAFE STREETS USA LLC (LEHI, UT) structures its employee benefits. Its broker of record is BLACK INK BENEFITS. Coverage is written through UNITED OF OMAHA LIFE INSURANCE COMPANY and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 27-4001370 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 597 | December | $15,718 |
| DELTA DENTAL INSURANCE COMPANY | Dental | 338 | December | $12,466 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 162 | December | $10,962 |
| USABLE LIFE | Life | 624 | December | $10,004 |
| VISION SERVICE PLAN | Vision | 203 | December | $3,270 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | — | 551 | December | $0 |
Questions
Who is SAFE STREETS USA LLC's benefits broker?
Per its most recent Form 5500 Schedule A, SAFE STREETS USA LLC's broker of record is BLACK INK BENEFITS.
What insurance carrier does SAFE STREETS USA LLC use?
SAFE STREETS USA LLC's benefit plan is written through UNITED OF OMAHA LIFE INSURANCE COMPANY, among 6 disclosed carriers.
When does SAFE STREETS USA LLC's group plan renew?
The most recent Schedule A policy period for SAFE STREETS USA LLC ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from SAFE STREETS USA LLC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.