Plan Ledger DOL Form 5500 · updated monthly

Black Rock Coffee Holdings, LLCbenefits

Black Rock Coffee Holdings, LLC Health & Welfare Plan · SCOTTSDALE, AZ · plan year 2024

Broker compensation reported · 2024
$67,624

Black Rock Coffee Holdings, LLC's benefits plans covered 544 active participants in 2024, providing health · life · dental · vision · long-term disability · death benefits. Insurance brokers and agents were paid $67,624 in commissions and fees, costs that ultimately come out of what the employer and employees pay for coverage. That is $124 per covered person, below the median for employer plans that report broker pay. Broker pay rose 44% from $46,926 in 2023.

Insurance contracts · 20243
REGENCE BLUECROSS BLUESHIELD OF OREGON · health drug vision ppopremiums n/a · 288 covered
OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON · dentalpremiums n/a · 302 covered
USABLE LIFE · life ltdpremiums n/a · 544 covered
Brokers & agents paid · 20242
USI INSURANCE SERVICES NORTHWEST$56,957 · incl $132 fees
Also brokered by Usi5
The Faison Center VA$1,640,677

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Source: DOL Form 5500 Schedule A, plan year 2024, EIN 831415331 · Verify on EFAST2 · Amounts are as reported by the plan sponsor.