# BELLEVILLE SHOE MANUFACTURING CO. GROUP MEDICAL PLAN

Health and welfare plan sponsored by **BELLEVILLE SHOE MANUFACTURING CO.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | BELLEVILLE SHOE MANUFACTURING CO. |
| EIN | 370173680 |
| Plan number | 502 |
| Plan year | 2025 |
| Location | BELLEVILLE, IL |
| Industry | Manufacturing |
| Funding | mixed |
| Total premiums | $487K |
| Participants | 409 |
| Persons covered | 537 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| TOKIO MARINE HCC | Stop-loss |
| DELTA DENTAL PLAN OF ARKANSAS | Dental |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, Other |
| UNITEDHEALTHCARE INSURANCE COMPANY | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| ALTERNATIVE RISK SOLUTIONS, LLC | THE NORTH RIVER INSURANCE COMPANY |
| HEDAYAT NEZHADPOUR | DELTA DENTAL PLAN OF ARKANSAS |
| DIGITAL INSURANCE LLC | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA |
| DIGITAL INSURANCE LLC | UNITEDHEALTHCARE 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/370173680-502
- Cite as: PlanOptica, https://planoptica.com/welfare/370173680-502
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