# P.W. GILLIBRAND GROUP HEALTH PLAN

Health and welfare plan sponsored by **P.W. GILLIBRAND CO., INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | P.W. GILLIBRAND CO., INC. |
| EIN | 461570382 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | SIMI VALLEY, CA |
| Industry | mining & metals |
| Funding | fully insured |
| Total premiums | $4.6M |
| Participants | 187 |
| Persons covered | 489 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| BLUE SHIELD OF CALIFORNIA | Health, Rx, HMO, PPO |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life, Other, LTD, STD |
| AMERITAS LIFE INSURANCE CORP. | Dental |
| EYEMED VISION CARE | Vision, Dental |
| LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | Dental |

## Brokers

| Broker | Placed with |
|---|---|
| BB&H BENEFIT DESIGNS | BLUE SHIELD OF CALIFORNIA |
| BB&H BENEFIT DESIGNS | AMERITAS LIFE INSURANCE CORP. |
| BB&H BENEFIT DESIGNS | RELIANCE STANDARD LIFE INSURANCE COMPANY |
| BB&H BENEFIT DESIGNS | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPA |
| BB&H BENEFIT DESIGNS | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE C |
| BB&H BENEFIT DESIGNS | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. |

## 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/461570382-501
- Cite as: PlanOptica, https://planoptica.com/welfare/461570382-501
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