# PINE BELT AUTO GROUP INSURANCE PLAN

Health and welfare plan sponsored by **PINE BELT ENTERPRISES, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | PINE BELT ENTERPRISES, INC. |
| EIN | 210537055 |
| Plan number | 503 |
| Plan year | 2025 |
| Location | LAKEWOOD, NJ |
| Industry | automotive |
| Funding | fully insured |
| Total premiums | $220K |
| Participants | 148 |
| Persons covered | 141 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| AFLAC | Life, STD, Other |
| DELTA DENTAL OF NEW JERSEY, INC. | Dental |
| AMERICAN FIDELITY ASSURANCE COMPANY | STD, LTD, Other |
| USABLE LIFE | Life, Other |
| METLIFE LEGAL PLANS | Vision |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Health, STD, Other |

## Brokers

| Broker | Placed with |
|---|---|
| MICHAEL J. RAGUSA | AFLAC |
| BRIAN M DENOIA | AFLAC |
| CHRISTOPHER J BURRIS | AFLAC |
| CHRISTOPHER MCNAMEE | AFLAC |
| JESSICA MOST | AFLAC |
| J&R INS AGENCY & FINANCIAL SERV LLC | AFLAC |
| MITCHELL N HNATT | AFLAC |
| ANTHONY BUNN | AFLAC |
| MICHAEL BUTTERFIELD | AFLAC |
| GAIL R BERGER | AFLAC |
| CONNER STRONG & BUCKELEW | DELTA DENTAL OF NEW JERSEY, INC. |
| NJ CAR SERVICES, INC. | AMERICAN FIDELITY ASSURANCE COMPANY |
| CONNER STRONG & BUCKELEW | USABLE LIFE |
| HORIZON INSURANCE COMPANY | USABLE LIFE |
| CONNER STRONG & BUCKELEW | NATIONAL VISION ADMINISTRATORS, L.L.C. |
| NATIONAL ENROLLMENT PARTNERS LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| SOTERIA PARTNERS LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| WILLIAM E GOOD | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/210537055-503
- Cite as: PlanOptica, https://planoptica.com/welfare/210537055-503
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