# GREEN DOT PUBLIC SCHOOLS NATIONAL HEALTH AND WELFARE PLAN

Health and welfare plan sponsored by **GREEN DOT PUBLIC SCHOOLS NATIONAL**. Form 5500 filing for plan year 2024.

| Field | Value |
|---|---|
| Sponsor | GREEN DOT PUBLIC SCHOOLS NATIONAL |
| EIN | 465740783 |
| Plan number | 501 |
| Plan year | 2024 |
| Location | LOS ANGELES, CA |
| Industry | primary/secondary education |
| Funding | fully insured |
| Total premiums | $17.1M |
| Participants | 0 |
| Persons covered | 1,291 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| ANTHEM LIFE INSURANCE COMPANY | Health, Rx, Vision, HMO, PPO |
| KAISER PERMANENTE | Health, Rx, HMO |
| AETNA LIFE INSURANCE COMPANY | Health, Rx, HMO, Dental, Other |
| LINCOLN FINANCIAL GROUP | Life, Other, LTD, STD |
| METLIFE LEGAL PLANS | Dental |
| SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | Dental, Other |
| VISION SERVICE PLAN (VSP) | Vision |
| AFLAC | Health, Indemnity, Other |
| HEALTH AND HUMAN RESOURCE CENTER | Other |
| SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | Dental, Other |

## Brokers

| Broker | Placed with |
|---|---|
| MERCER HEALTH AND BENEFITS, LLC | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY |
| MERCER HEALTH AND BENEFITS, LLC | KAISER FOUNDATION HEALTH PLAN, INC. |
| MERCER HEALTH AND BENEFITS, LLC | AETNA HEALTH, INC. |
| MERCER HEALTH AND BENEFITS, LLC | AETNA LIFE INSURANCE COMPANY |
| MERCER HEALTH AND BENEFITS, LLC | METROPOLITAN LIFE INSURANCE COMPANY |
| MERCER HEALTH AND BENEFITS, LLC | LINCOLN NATIONAL LIFE INSURANCE COMPANY |
| MERCER HEALTH AND BENEFITS, LLC | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION |
| JACOB BURNS INC. | AFLAC |
| KATRINA LAFATA | AFLAC |
| MERCER HEALTH AND BENEFITS, LLC | AFLAC |
| MICHAEL R FISHER | AFLAC |
| ELDRIDGE MOORE | AFLAC |
| JOHN CHRISTENSEN | 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/465740783-501
- Cite as: PlanOptica, https://planoptica.com/welfare/465740783-501
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