Form 5500 · Employee benefit plan · CITY OF INDUSTRY, CA
SIGNATURE FLEXIBLE PACKAGING, INC.
The filing calls this plan SIGNATURE FLEXIBLE PACKAGING, INC. DBA DAZPAK.
SIGNATURE FLEXIBLE PACKAGING, INC. of CITY OF INDUSTRY, CA spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is AON RISK SERVICES INC OF FLORIDA. Coverage is written through BLUE CROSS OF CALIFORNIA and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 13-4076379 · plan 501 · plan year 2023, filed Jul 30, 2024
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: other welfare.
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 10 insured contracts covering health, dental, vision and life; the largest, with BLUE CROSS OF CALIFORNIA, covers 216 people.
Reported premium across the insured contracts is $1,634,849, with $117,301 in disclosed broker commissions — about 7.2% 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.
AON RISK SERVICES INC OF FLORIDA is the broker of record on 1 of the 10 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including BLUE CROSS OF CALIFORNIA, CIGNA HEALTH AND LIFE INSURANCE COMPANY, LIFE INSURANCE COMPANY OF NORTH AMERICA and CIGNA DENTAL HEALTH OF OHIO, INC.. BLUE CROSS OF CALIFORNIA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS OF CALIFORNIA | Health | 216 | Jan 1, 2024 | $1,510,952 | $96,948 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental, Vision | 115 | Jan 1, 2024 | $69,572 | $6,914 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life | 237 | Jan 1, 2024 | $25,493 | $3,824 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 53 | Jan 1, 2024 | $5,944 | $3,464 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 26 | Jan 1, 2024 | $5,200 | $2,628 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | 34 | Jan 1, 2024 | $4,097 | $2,018 |
| CIGNA DENTAL HEALTH OF OHIO, INC. | Dental | 39 | Jan 1, 2024 | $6,225 | $623 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | — | 237 | Jan 1, 2024 | $2,906 | $436 |
| CIGNA HEALTHCARE OF CALIFORNIA | Dental | 26 | Jan 1, 2024 | $4,181 | $418 |
| CIGNA DENTAL HEALTH OF VIRGINIA, INC. | Dental | 2 | Jan 1, 2024 | $279 | $28 |
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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