# ARCHIVAL FOUNDATION WELFARE BENEFITS PLAN

Health and welfare plan sponsored by **ARCHIVAL FOUNDATION**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | ARCHIVAL FOUNDATION |
| EIN | 204366551 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | BEVERLY HILLS, CA |
| Industry | Other Services |
| Funding | fully insured |
| Total premiums | $9.2M |
| Participants | 522 |
| Persons covered | 484 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental, HMO, PPO, Indemnity |
| STANDARD INSURANCE COMPANY | LTD, STD, Life, Other |
| VISION SERVICE PLAN (VSP) | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| PG INSURANCE SERVICES INC. | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES |
| PAUL GAARENSTROOM | VISION SERVICE PLAN |
| PG INSURANCE SERVICES INC. | STANDARD 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/204366551-501
- Cite as: PlanOptica, https://planoptica.com/welfare/204366551-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers