# LAKESIDE SURFACES, LLC HEALTH & WELFARE BENEFIT PLAN

Health and welfare plan sponsored by **LAKESIDE SURFACES, LLC**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | LAKESIDE SURFACES, LLC |
| EIN | 383594873 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | MUSKEGON, MI |
| Industry | building materials |
| Funding | fully insured |
| Total premiums | $933K |
| Participants | 186 |
| Persons covered | 206 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| PRIORITY HEALTH | Health, Rx, HMO |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, STD, LTD, Other |
| METLIFE LEGAL PLANS | Dental |
| EYEMED VISION CARE | Vision |
| ULLIANCE, INC. | Other |

## Brokers

| Broker | Placed with |
|---|---|
| CARMAN M. BAINES | PRIORITY HEALTH |
| HYLANT GROUP INC | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| HYLANT GROUP INC | METROPOLITAN LIFE INSURANCE COMPANY |
| MMA SERVICE CORP | METROPOLITAN LIFE INSURANCE COMPANY |
| HUB INTERNATIONAL MIDWEST LIMITED | METROPOLITAN LIFE 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/383594873-501
- Cite as: PlanOptica, https://planoptica.com/welfare/383594873-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers