Libbey Glass LLC
Overview
Libbey Glass LLC sponsors a self-funded health plan that covered 718 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
- 718 · prior year 708
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Libbey Union Employees Welfare Benefit Plan, plan 506 (718 participants); Libbey Retiree Welfare Benefit Plan, plan 501 (482 participants); Libbey Welfare Benefit Plan, plan 505 (449 participants); Libbey Union Retiree Welfare Benefit Plan, plan 502 (97 participants)
- Broker compensation
- $14K 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 |
|---|---|---|---|---|
| Hartford Life and Accident Insurance Company | Life, Voluntary AD&D, Long-term disability, NJ STD, Business Travel Accident, New York Statutory | 641 | $722K | $14K |
| Eyemed | Vision | 737 | $119K | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 718 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
- Libbey Glass LLC
- Sponsor EIN
- 22-2784107
- Plan numbers
- 506, 501, 505, 502
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 22-2784107 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Libbey Hourly Retirement Plan
- Type
- Pension plan
- Participants
- 2,256
About this data
Source: Libbey Glass 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 Libbey Glass LLC.