Coverage by line
Premium dollars by benefit type (bundled lines overlap)
- Dental$294K
- Vision$294K
- Life$294K
- Short-term disability$294K
- Long-term disability$294K
- Other$294K
Premium dollars by benefit type (bundled lines overlap)
Premium dollars by Schedule A carrier
Schedule A broker compensation
401k
Fully Insured - HUMANA INSURANCE COMPANY
Self Funded
| Plan # | Name | Type | Assets | Participants | Latest year | |
|---|---|---|---|---|---|---|
| 001 | FORMS & SUPPLY, INC. 401(K) PLAN | 401k | $11.5M | 299 | 2024 |
| Plan # | Name | Funding | Carrier | Premiums | Covered | Latest year | |
|---|---|---|---|---|---|---|---|
| 502 | FORMS & SUPPLY INC BENEFIT PLAN | Fully Insured | HUMANA INSURANCE COMPANY | $294K | 233 | 2025 | |
| 501 | FORMS & SUPPLY SELF-FUNDED MEDICAL AND PRESCRIPTION DRUG PLAN | Self Funded | - | $0 | 0 | 2025 |