Form 5500 · Employee benefit plan · MONROVIA, CA
VINYL TECHNOLOGY LLC
The filing calls this plan VINYL TECHNOLOGY LIFE PLAN.
VINYL TECHNOLOGY LLC of MONROVIA, CA spreads its employee benefits across 5 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is HUB INTERNATIONAL OF CA INS. SVCS.. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-3784784 · plan 501 · plan year 2024, filed Jul 24, 2025
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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
Disability: UNUM LIFE INSURANCE COMPANY OF AMERICA covers 10 of 163 participants (6.1%) on Schedule A.
Also declared: death benefits.
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 5 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 83 people.
Reported premium across the insured contracts is $650,376, with $44,761 in disclosed broker commissions — about 6.9% 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.
HUB INTERNATIONAL OF CA INS. SVCS. is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., UNITED OF OMAHA LIFE INSURANCE COMPANY, UNUM LIFE INSURANCE COMPANY OF AMERICA and LIBERTY DENTAL PLAN OF CALIFORNIA, INC.. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 83 | Jan 1, 2025 | $614,309 | $40,589 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 207 | Jan 1, 2025 | $20,482 | $2,048 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 10 | Jan 1, 2025 | $7,457 | $1,231 |
| LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | Dental | 44 | Jan 1, 2025 | $4,071 | $487 |
| AMERITAS LIFE INSURANCE CORP. | Vision | 79 | Jan 1, 2025 | $4,057 | $406 |
Premium and claims on this contract
LIBERTY DENTAL PLAN OF CALIFORNIA, INC., contract AMCA055. For the contract year on this filing, the carrier reported $4,071 in premium earned and $36 in claims incurred. Dividing one by the other gives 1%.
- LIBERTY DENTAL PLAN OF CALIFORNIA, INC., contract AMCA055 reported $1,721 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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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