Form 5500 · Employee benefit plan · OGDEN, UT
USA DOLLAR STORES INC
Public Form 5500 records show how USA DOLLAR STORES INC of OGDEN, UT, a transportation and logistics employer, structures its employee benefits. Its broker of record is BANASKY AN ALERA INS AGCY. Coverage is written through HEALTH SELECT and 1 other carrier. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 46-5215996 · plan 501 · as of Aug 2026
Plan brief
Schedule A lists 2 insured contracts covering health, dental, vision and life; the largest, with HEALTH SELECT, covers 82 people.
Reported premium across the insured contracts is $203,661, with $26,260 in disclosed broker commissions — about 13% of premium.
The most recent policy period ended in July, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
BANASKY AN ALERA INS AGCY is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: HEALTH SELECT and PRINCIPAL LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| PRINCIPAL LIFE INSURANCE COMPANY | Dental, Vision, Life | 298 | July | $93,888 | $15,294 |
| HEALTH SELECT | Health | 82 | July | $109,773 | $10,966 |
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