# BLAIR ACADEMY WELFARE BENEFIT PLAN

Health and welfare plan sponsored by **BLAIR ACADEMY**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | BLAIR ACADEMY |
| EIN | 221500475 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | BLAIRSTOWN, NJ |
| Industry | primary/secondary education |
| Funding | mixed |
| Total premiums | $233K |
| Participants | 139 |
| Persons covered | 263 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| DELTA DENTAL OF NEW JERSEY, INC. | Dental |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | STD, Life, Other, LTD |
| VISION SERVICE PLAN (VSP) | Vision |
| AFLAC | Other |

## Brokers

| Broker | Placed with |
|---|---|
| PATRIOT GROWTH INSURANCE SERVICES | DELTA DENTAL OF NEW JERSEY, INC. |
| PROFESSIONAL GROUP PLANS INC | DELTA DENTAL OF NEW JERSEY, INC. |
| PATRIOT GROWTH INSURANCE SERVICES | RELIANCE STANDARD LIFE INSURANCE COMPANY |
| TRUE NETWORK ADVISORS | RELIANCE STANDARD LIFE INSURANCE COMPANY |
| PATRIOT GROWTH INSURANCE SERVICES | VISION SERVICE PLAN |
| YANIS E KALOUDIS | AFLAC |
| MICHAEL P ZORN | AFLAC |
| MICHAEL C WALKER | AFLAC |
| TYLER KNIGHT | AFLAC |
| MATTHEW G BERGER | AFLAC |
| ALBERT SHUST | AFLAC |
| DAVID MORNINGSTAR | AFLAC |
| ROBERT TOWNSEND | AFLAC |
| MICHAEL A FORNARO | AFLAC |
| BETH E FREDERICKSON | AFLAC |
| AMY K FOY | AFLAC |
| REY ROSTAMI | AFLAC |
| TARA MICHELLE D AGOSTINO | AFLAC |

## 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/221500475-501
- Cite as: PlanOptica, https://planoptica.com/welfare/221500475-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers