Form 5500 · Employee benefit plan · COLUMBUS, OH
SAFELITE GROUP, INC.
The filing calls this plan SAFELITE GROUP INC ASSOC BEN PLAN INSURED PLAN.
SAFELITE GROUP, INC. of COLUMBUS, OH files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MARSH USA INC. Coverage is written through PRUDENTIAL INSURANCE COMPANY OF AMERICA and 10 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 31-1725961 · plan 602 · plan year 2024, filed Oct 9, 2025
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2,504 other employer plans in Ohio have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Health: the largest of the 6 insured health contracts, with KAISER FOUNDATION HEALTH PLAN, INC., covers 694 of 16,066 participants (4.3%) on Schedule A.
Also declared: prepaid legal, death benefits.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 11 insured contracts covering health, dental, vision, life and disability; the largest, with PRUDENTIAL INSURANCE COMPANY OF AMERICA, covers 14,191 people.
Reported premium across the insured contracts is $25,959,305, with $1,154,682 in disclosed broker commissions — about 4.4% 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.
MARSH USA INC is the broker of record on 1 of the 11 contracts; the rest name a different broker or none.
11 carriers appear on the filing, including PRUDENTIAL INSURANCE COMPANY OF AMERICA, DELTA DENTAL OF OHIO, KAISER FOUNDATION HEALTH PLAN, INC. and AMERICAN HERITAGE LIFE INSURANCE COMPANY. PRUDENTIAL INSURANCE COMPANY OF AMERICA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PRUDENTIAL INSURANCE COMPANY OF AMERICA | Life, Disability | 14,191 | Jan 1, 2025 | $9,799,040 | $508,880 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | 4,073 | Jan 1, 2025 | $2,379,946 | $475,619 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 694 | Jan 1, 2025 | $3,646,029 | $63,747 |
| LEGALPLANS, USA | — | 1,786 | Jan 1, 2025 | $353,959 | $53,094 |
| KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | Health | 84 | Jan 1, 2025 | $706,151 | $13,843 |
| KAISER FOUNDATION HEALTH PLAN OF COLORADO | Health | 112 | Jan 1, 2025 | $710,416 | $11,894 |
| KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | Health | 103 | Jan 1, 2025 | $544,683 | $11,152 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | Health | 31 | Jan 1, 2025 | $198,238 | $8,373 |
| KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | Health | 63 | Jan 1, 2025 | $357,420 | $8,080 |
| DELTA DENTAL OF OHIO | Dental | 15,737 | Jan 1, 2025 | $6,154,340 | $0 |
| VISION SERVICE PLAN | Vision | 7,782 | Jan 1, 2025 | $1,109,083 | $0 |
Premium and claims on this contract
DELTA DENTAL OF OHIO, contract 10891. For the contract year on this filing, the carrier reported $6,154,340 in premium earned and $4,671,036 in claims incurred. Dividing one by the other gives 76%.
- DELTA DENTAL OF OHIO, contract 10891 reported $452,959 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Administrator and service providers
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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Renewal calendar
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