# ROGER CLEVELAND GOLF CO., INC. BENEFIT PLAN

Health and welfare plan sponsored by **ROGER CLEVELAND GOLF CO., INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | ROGER CLEVELAND GOLF CO., INC. |
| EIN | 953838879 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | HUNTINGTON BEACH, CA |
| Industry | electrical/electronic manufacturing |
| Funding | fully insured |
| Total premiums | $6.1M |
| Participants | 457 |
| Persons covered | 774 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| NIPPON LIFE INSURANCE COMPANY OF AMERICA | Health, Rx |
| AETNA LIFE INSURANCE COMPANY | Dental, Vision |
| MUTUAL OF OMAHA INSURANCE COMPANY | Life, STD, LTD, Other |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | STD, Other |
| UNUMPROVIDENT | Health, Rx |
| FEDERAL INSURANCE COMPANY | Other |

## Brokers

| Broker | Placed with |
|---|---|
| ACRISURE LLC | NIPPON LIFE INSURANCE COMPANY OF AMERICA |
| BENEFITS AMERICA INS. SRVCS LLC | AETNA LIFE INSURANCE COMPANY |
| BENEFITS AMERICA INS. SVCS., LLC | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| BENEFITS AMERICA INSURANCE SERVICES | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| MCCAREY INC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DANA MARIE MOWATT | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| RONNY ANN WARNER | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| MARIA VERONICA JARQUE | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| KRISTIN LEASE | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ASSUREDPARTNERS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DANA MARIE MOWATT | THE PAUL REVERE LIFE INSURANCE COMPANY |
| KRISTIN LEASE | THE PAUL REVERE LIFE INSURANCE COMPANY |
| MCCAREY INC | THE PAUL REVERE LIFE INSURANCE COMPANY |
| BENEFITS AMERICA INSURANCE SERVICES | THE PAUL REVERE LIFE INSURANCE COMPANY |
| RONNY ANN WARNER | THE PAUL REVERE LIFE INSURANCE COMPANY |
| SAMAR BREIK ALBIN | THE PAUL REVERE LIFE INSURANCE COMPANY |
| MARIA VERONICA JARQUE | THE PAUL REVERE 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/953838879-501
- Cite as: PlanOptica, https://planoptica.com/welfare/953838879-501
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