Fiesta Restaurant Group, Inc.
Overview
Fiesta Restaurant Group, Inc. sponsors a self-funded health plan that covered 500 participants in plan year 2025, about the same as 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
- 500 · prior year 500
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Fiesta Restaurant Group, Inc. Health & Welfare Benefits Plan, plan 501 (500 participants)
- Stop-loss carrier
- Reliastar Life Insurance Company
- Broker compensation
- $118K 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 |
|---|---|---|---|---|
| Reliastar Life Insurance Company | Stop-loss | 218 | $553K | $86K |
| Life Insurance Company of North America | Life, Short-term disability, Long-term disability | 500 | $237K | $2K |
| UnitedHealthcare Insurance Company of New York | Dental, Vision | 145 | $222K | $23K |
| American Heritage Life Insurance Company | Life, Short-term disability | 124 | $81K | $6K |
| Magellan Healthcare | Employee Assistance Program | 500 | $15K | — |
| Hartford Life and Accident | Business Travel Accident | 500 | $2K | $408 |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 500 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
- Fiesta Restaurant Group, Inc.
- Sponsor EIN
- 90-0712224
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 90-0712224 in the Department of Labor's EFAST2 Form 5500 search.
About this data
Source: Fiesta Restaurant Group, Inc.'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 Fiesta Restaurant Group, Inc..