# LEE JOHNSON CHEVROLET INC. WELFARE BENEFITS PLAN

Health and welfare plan sponsored by **LEE JOHNSON CHEVROLET INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | LEE JOHNSON CHEVROLET INC. |
| EIN | 910817749 |
| Plan number | 502 |
| Plan year | 2025 |
| Location | KIRKLAND, WA |
| Industry | aviation & aerospace |
| Funding | fully insured |
| Total premiums | $1.0M |
| Participants | 274 |
| Persons covered | 596 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| KAISER PERMANENTE | Health, Rx, PPO, HMO |
| AMERITAS LIFE INSURANCE CORP. | Dental, Vision |
| WILLAMETTE DENTAL INSURANCE, INC. | Dental |

## Brokers

| Broker | Placed with |
|---|---|
| USI INSURANCE SERVICES LLC | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. |
| USI INSURANCE SERVICES LLC | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON |
| USI INSURANCE SERVICES LLC | AMERITAS LIFE INSURANCE CORPORATION |
| USI INSURANCE SERVICES LLC | WILLAMETTE DENTAL OF WASHINGTON, 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/910817749-502
- Cite as: PlanOptica, https://planoptica.com/welfare/910817749-502
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers