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Form 5500 · Employee benefit plan · AGOURA HILLS, CA

STONEFIRE GRILL, INC.

The filing calls this plan STONEFIRE GRILL, INC. BENEFITS PLAN.

Public Form 5500 records show how STONEFIRE GRILL, INC. of AGOURA HILLS, CA, a hospitality and food service employer, structures its employee benefits. Its broker of record is HUB INTERNATIONAL NORTHEAST LIMITED. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in August.

Benefits broker of record
Policy year ends
Augustas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 27-0110509 · plan 502 · plan year 2025, filed Jun 11, 2026

Get an email when this employer files a new Form 5500, and again about four months before its plan renews.

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.

All participants at the start of the year
125
Active at start of year
124
Active at end of year
110
Disclosed commissions
$40,950
Typical renewal
September 1

Benefits declared on this filing

Healthinsured — UNITEDHEALTHCARE INSURANCE COMPANY263 of 125 participants
Dentalinsured — UNITEDHEALTHCARE INSURANCE COMPANY263 of 125 participants
Visioninsured — UNITEDHEALTHCARE INSURANCE COMPANY263 of 125 participants
Lifeinsured — UNUM LIFE INSURANCE COMPANY OF AMERICA102 of 125 participants (82%)
Disabilityinsured — UNUM LIFE INSURANCE COMPANY OF AMERICA102 of 125 participants (82%)

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.

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 2 insured contracts covering health, dental, vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 263 people.

Reported premium across the insured contracts is $785,965, with $40,950 in disclosed broker commissions — about 5.2% of premium.

The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.

HUB INTERNATIONAL NORTHEAST LIMITED is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.

Two carriers split the book: UNITEDHEALTHCARE INSURANCE COMPANY and UNUM LIFE INSURANCE COMPANY OF AMERICA.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
UNITEDHEALTHCARE INSURANCE COMPANYHealth, Dental, Vision263Sep 1, 2025$760,634$37,911
UNUM LIFE INSURANCE COMPANY OF AMERICALife, Disability102Sep 1, 2025$25,331$3,039

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
STONEFIRE GRILL, INC.
EIN 27-0110509

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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