# ELECTRONIC WAVEFORM LAB BENEFIT AND WELFARE PLAN

Health and welfare plan sponsored by **ELECTRONIC WAVEFORM LAB, INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | ELECTRONIC WAVEFORM LAB, INC. |
| EIN | 953730701 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | HUNTINGTON BEACH, CA |
| Industry | Manufacturing |
| Funding | fully insured |
| Total premiums | $481K |
| Participants | 184 |
| Persons covered | 272 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Rx, Dental, PPO |
| PRINCIPAL FINANCIAL GROUP | Vision, Life |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, STD, Other |

## Brokers

| Broker | Placed with |
|---|---|
| USI INSURANCE SERVICES LLC | CIGNA HEALTH AND LIFE INSURANCE COMPANY |
| RICHARD WAYNE BRYSON | CIGNA HEALTH AND LIFE INSURANCE COMPANY |
| USI INSURANCE SERVICES LLC | PRINCIPAL LIFE INSURANCE COMPANY |
| PROFESSIONAL GROUP PLANS INC | PRINCIPAL LIFE INSURANCE COMPANY |
| BRYSON INSURANCE AGENCY INC. | PRINCIPAL LIFE INSURANCE COMPANY |
| JOHN D EVANGELISTA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DIGITAL INSURANCE LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| TECH COORDINATOR CYBER INSURANCE SO | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| USI INSURANCE SERVICES LLC | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ANTOINETTE MARI GARCIA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| NICHOLAS RYAN DERRICO | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| BRYSON INSURANCE AGENCY INC. | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| KRISTIN ANN DECOU | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ANDREA MARIE TIERCE | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DANA MARIE MOWATT | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| ERIC ALEXANDER NOVOA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| UZIEL RIVERA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| DONNA TROXELL | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| EDITH VIEYRA | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| BENECHOICE ENROLLMENT SOLUTIONS | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY |
| JAMES BARTLETT LLC | COLONIAL LIFE & ACCIDENT 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/953730701-501
- Cite as: PlanOptica, https://planoptica.com/welfare/953730701-501
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