# NORTHEAST VALLEY HEALTH CORP. WRAP BENEFIT PLAN

Health and welfare plan sponsored by **NORTHEAST VALLEY HEALTH CORPORATION**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | NORTHEAST VALLEY HEALTH CORPORATION |
| EIN | 237120632 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | SYLMAR, CA |
| Industry | medical practice |
| Funding | fully insured |
| Total premiums | $15.9M |
| Participants | 926 |
| Persons covered | 1,559 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| KAISER PERMANENTE | Health |
| BLUE SHIELD OF CALIFORNIA | Health, Rx |
| MUTUAL OF OMAHA INSURANCE COMPANY | LTD, Life, Other, STD |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Dental, HMO, Indemnity |
| EYEMED VISION CARE | Vision |
| PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | Other |

## Brokers

| Broker | Placed with |
|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | KAISER FOUNDATION HEALTH PLAN INC |
| GALLAGHER BENEFIT SERVICES, INC. | BLUE SHIELD OF CALIFORNIA |
| GALLAGHER BENEFIT SERVICES, INC. | CIGNA HEALTH AND LIFE INSURANCE COMPANY |
| GALLAGHER BENEFIT SERVICES, INC. | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| FMLASOURCE INC | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| GALLAGHER BENEFIT SERVICES, INC. | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. |
| GALLAGHER BENEFIT SERVICES, INC. | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |
| GALLAGHER BENEFIT SERVICES, INC. | MUTUAL OF OMAHA 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/237120632-501
- Cite as: PlanOptica, https://planoptica.com/welfare/237120632-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers