Black Box Services LLC
Overview
Black Box Services LLC sponsors a self-funded health plan that covered 1,443 participants in plan year 2025, down 7% from the prior year. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, vision, short-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 1,443 · prior year 1,556
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Black Box Services Company Wrap Plan, plan 501 (1,443 participants)
- Stop-loss carrier
- Berkley Life and Health Insurance Company
- Broker compensation
- $221K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| Lincoln National Life Insurance Company | Life, Long-term disability | 1,303 | $906K | $58K |
| Delta Dental of Delaware | Dental | 2,100 | $848K | — |
| The Lincoln National Life Insurance Company | Critical Illness, Accident, Hospital Indemnity | 560 | $355K | $54K |
| Fidelity Security Life Insurance Company | Vision | 1,839 | $57K | $4K |
| MetLife Legal Plans | Legal | 109 | $27K | $3K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 1,443 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2025
- Plan sponsor
- Black Box Services LLC
- Sponsor EIN
- 47-5380117
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 47-5380117 in the Department of Labor's EFAST2 Form 5500 search.
About this data
Source: Black Box Services LLC's Form 5500 filing for plan year 2025 and its Schedule A insurance reports, published by the U.S. Department of Labor. "Self-funded" means the filing reports benefits paid from employer assets or a trust, with no medical insurance contract or with a stop-loss contract. Pharmacy figures are StreamRX estimates based on national averages. StreamRX is not affiliated with Black Box Services LLC.