Form 5500 · Employee benefit plan · ROGERSVILLE, TN
SAM DONG, INC.
SAM DONG, INC.'s employee benefit plan is documented in its annual Form 5500 filing with the Department of Labor. Its broker of record is GUY MORRISON. Coverage is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 26-0719151 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| BLUECROSS BLUESHIELD OF TENNESSEE, INC | Health, Vision | 391 | December | $116,776 |
| USABLE LIFE | Life, Disability | 295 | December | $58,400 |
| DELTA DENTAL OF TENNESSEE | Dental | 448 | December | $6,122 |
Questions
Who is SAM DONG, INC.'s benefits broker?
Per its most recent Form 5500 Schedule A, SAM DONG, INC.'s broker of record is GUY MORRISON.
What insurance carrier does SAM DONG, INC. use?
SAM DONG, INC.'s benefit plan is written through BLUECROSS BLUESHIELD OF TENNESSEE, INC, among 3 disclosed carriers.
When does SAM DONG, INC.'s group plan renew?
The most recent Schedule A policy period for SAM DONG, INC. ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from SAM DONG, INC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.