Form 5500 · Employee benefit plan · SANTA CRUZ, CA
VERVE LLC DBA VERVE COFFEE ROASTERS
The filing calls this plan VERVE LLC DBA VERVE COFFEE ROASTERS WELFARE BENEFITS PLAN.
VERVE LLC DBA VERVE COFFEE ROASTERS of SANTA CRUZ, CA is a 100-participant hospitality and food service employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is ACRISURE PARTNERS WEST COAST INSURA. Coverage is written through NATIONAL GUARDIAN LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-2298665 · plan 501 · plan year 2025, filed Jun 16, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
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 dental and life; the largest, with NATIONAL GUARDIAN LIFE INSURANCE COMPANY, covers 105 people.
Reported premium across the insured contracts is $70,703, with $5,971 in disclosed broker commissions — about 8.4% 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.
ACRISURE PARTNERS WEST COAST INSURA is the broker of record on 1 of the 2 contracts; the rest name a different broker or none.
Two carriers split the book: NATIONAL GUARDIAN LIFE INSURANCE COMPANY and EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| NATIONAL GUARDIAN LIFE INSURANCE COMPANY | Dental | 105 | Jan 1, 2026 | $62,516 | $5,001 |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Life | 143 | Jan 1, 2026 | $8,187 | $970 |
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.
Reported to OSHA
Reported to OSHA for 2025: 253 employees, 8 recordable cases, 33 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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