# BLUE RIDGE ACADEMY WRAP BENEFIT PLAN

Health and welfare plan sponsored by **BLUE RIDGE ACADEMY**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | BLUE RIDGE ACADEMY |
| EIN | 821850228 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | MARICOPA, CA |
| Industry | Educational Services |
| Funding | fully insured |
| Total premiums | $8.6M |
| Participants | 500 |
| Persons covered | 935 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| BLUE SHIELD OF CALIFORNIA | Health, Rx, HMO, PPO |
| KAISER PERMANENTE | Health, Rx, HMO |
| MUTUAL OF OMAHA INSURANCE COMPANY | STD, Other, LTD, Life |
| DELTA DENTAL OF CALIFORNIA | Dental |
| EYEMED VISION CARE | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| MARSH & MCLENNAN AGENCY LLC | CALIFORNIA PHYSICIANS SERVICE |
| MARSH & MCLENNAN AGENCY LLC | KAISER FOUNDATION HEALTH PLAN, INC. |
| GALLAGHER BENEFIT SERVICES, INC. | KAISER FOUNDATION HEALTH PLAN, INC. |
| MARSH & MCLENNAN AGENCY LLC | DELTA DENTAL OF CALIFORNIA |
| MARSH & MCLENNAN AGENCY LLC | UNITED OF OMAHA LIFE INSURANCE COMPANY |
| FMLASOURCE INC | UNITED OF OMAHA LIFE 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/821850228-501
- Cite as: PlanOptica, https://planoptica.com/welfare/821850228-501
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