Hartz Mountain Industries, Inc.
Overview
Hartz Mountain Industries, Inc. sponsors a self-funded health plan that covered 515 participants in plan year 2024. The plan year starts in July. Alongside medical, its benefits filing reports life insurance, dental, vision, long-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 515
- Plan year
- Begins July 1 · next renewal July 2027
- Health plans filed
- Health and Welfare Benefit Plan, plan 501 (515 participants)
- Stop-loss carrier
- Aetna Life Insurance Co.
- Broker compensation
- $2.2M 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 |
|---|---|---|---|---|
| Aetna Life Insurance Co. | Dental, Stop-loss | 370 | $1.3M | $63K |
| Life Insurance Company of North America | AD&D, Voluntary AD&D, Life, Long-term disability | 484 | $201K | $4K |
| Delta Dental of New Jersey, Inc. | Dental | 219 | $122K | $4K |
| New York Life Group Insurance Company of New York | Family Leave Insurance | 466 | $122K | $3K |
| Vision Service Plan | Vision | 256 | $28K | $2K |
| Carelon RX | Prescription drug | 413 | — | $2.1M |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 515 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 2024
- Plan sponsor
- Hartz Mountain Industries, Inc.
- Sponsor EIN
- 13-2670903
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 13-2670903 in the Department of Labor's EFAST2 Form 5500 search.
About this data
Source: Hartz Mountain Industries, Inc.'s Form 5500 filing for plan year 2024 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 Hartz Mountain Industries, Inc..