# WOODSTONE GOLF CLUB, INC. EMPLOYEE BENEFIT PLAN

Health and welfare plan sponsored by **WOODSTONE GOLF CLUB, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | WOODSTONE GOLF CLUB, INC. |
| EIN | 232971010 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | DANIELSVILLE, PA |
| Industry | Arts, Entertainment, and Recreation |
| Funding | mixed |
| Total premiums | $70K |
| Participants | 25 |
| Persons covered | 45 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| HM LIFE INSURANCE COMPANY | Stop-loss |
| CAPITAL ADVANTAGE ASSURANCE COMPANY | Vision |
| UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | Dental |
| HEALTHIEST YOU | Other |

## Brokers

| Broker | Placed with |
|---|---|
| BSI CORPORATE BENEFITS LLC | CAPITAL ADVANTAGE ASSURANCE COMPANY |
| BSI CORPORATE BENEFITS LLC | UNITED CONCORDIA 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/232971010-501
- Cite as: PlanOptica, https://planoptica.com/welfare/232971010-501
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