# BOULDER MEDICAL CENTER, P.C EMPLOYEE HEALTH AND WELFARE PLAN

Health and welfare plan sponsored by **BOULDER MEDICAL CENTER**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | BOULDER MEDICAL CENTER |
| EIN | 840834835 |
| Plan number | 503 |
| Plan year | 2025 |
| Location | BOULDER, CO |
| Industry | medical practice |
| Funding | fully insured |
| Total premiums | $4.3M |
| Participants | 429 |
| Persons covered | 432 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Dental, Indemnity |
| STANDARD INSURANCE COMPANY | LTD |
| LINCOLN FINANCIAL GROUP | Life, Other, LTD |
| VISION SERVICE PLAN (VSP) | Vision |
| PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | Other |

## Brokers

| Broker | Placed with |
|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES |
| HUB INTERNATIONAL MIDWEST LIMITED | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY |
| PATRIOT GROWTH INSURANCE SERVICES | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY |
| PATRIOT GROWTH INSURANCE SERVICES | VISION SERVICE PLAN |
| HUB INTERNATIONAL MIDWEST LIMITED | VISION SERVICE PLAN |
| HUB INTERNATIONAL MIDWEST LIMITED | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |
| PATRIOT GROWTH INSURANCE SERVICES | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |
| ROGERS BENEFIT GROUP INC | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD |

## 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/840834835-503
- Cite as: PlanOptica, https://planoptica.com/welfare/840834835-503
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers