# BODEGA LATINA HEALTH BENEFITS

Health and welfare plan sponsored by **CHEDRAUI USA** (dba BODEGA LATINA DBA EL SUPER). Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | CHEDRAUI USA |
| EIN | 954517472 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | COMMERCE, CA |
| Industry | executive office |
| Funding | mixed |
| Total premiums | $7.1M |
| Participants | 2,551 |
| Persons covered | 5,882 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, STD, LTD, Other |
| KAISER PERMANENTE | Health, Rx, HMO |
| CENTENE CORP. GRP. DBA HEALTH NET LIFE INSURANCE COMPANY | Health, Rx, HMO |
| ANTHEM LIFE INSURANCE COMPANY | Health, Rx, HMO, PPO |

## Brokers

| Broker | Placed with |
|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| CUSTOM BENEFIT PROGRAMS INC | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| HUB INTERNATIONAL MIDWEST LIMITED | UNUM LIFE INSURANCE COMPANY OF AMERICA |
| GALLAGHER BENEFIT SERVICES, INC. | HEALTH NET |
| GALLAGHER BENEFIT SERVICES, INC. | UNUM INSURANCE COMPANY |
| GALLAGHER BENEFIT SERVICES, INC. | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY |
| STEVEN RAY GRIFFIN | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY |
| CUSTOM BENEFIT PROGRAMS INC | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY |
| HUB INTERNATIONAL MIDWEST LIMITED | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY |
| AMWINS | PROVIDENT LIFE AND 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/954517472-501
- Cite as: PlanOptica, https://planoptica.com/welfare/954517472-501
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