# HAYFIELD WINDOW & DOOR COMPANY WELFARE BENEFIT PLAN

Health and welfare plan sponsored by **HAYFIELD WINDOW AND DOOR COMPANY LLC**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | HAYFIELD WINDOW AND DOOR COMPANY LLC |
| EIN | 842236243 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | HAYFIELD, MN |
| Industry | construction |
| Funding | fully insured |
| Total premiums | $1.3M |
| Participants | 211 |
| Persons covered | 211 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| BCBSMN, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | Health, Rx |
| METLIFE LEGAL PLANS | Life, Other |
| MUTUAL OF OMAHA INSURANCE COMPANY | Vision, Life, STD, LTD, Other |
| UNITEDHEALTHCARE INSURANCE COMPANY | Dental |

## Brokers

| Broker | Placed with |
|---|---|
| USI INSURANCE SERVICES LLC | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS |
| USI INSURANCE SERVICES LLC | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| USI INSURANCE SERVICES LLC | UNITEDHEALTHCARE INSURANCE COMPANY |
| UNKNOWN | METROPOLITAN TOWER LIFE INSURANCE COMPANY |
| JENNON CARUTH | METROPOLITAN LIFE INSURANCE COMPANY |
| USI INSURANCE SERVICES LLC | METROPOLITAN LIFE INSURANCE COMPANY |
| CLARITY BENEFIT CONSULTING LLC | 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/842236243-501
- Cite as: PlanOptica, https://planoptica.com/welfare/842236243-501
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