Form 5500 · Employee benefit plan · CHICAGO, IL
BMO FINANCIAL CORP
The filing calls this plan BANK OF THE WEST RETIREE MEDICAL PLAN.
BMO FINANCIAL CORP of CHICAGO, IL files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is WILLIS TOWERS WATSON US LLC. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC.. The plan's most recent policy period ended in August.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 51-0275712 · plan 515 · plan year 2023, filed Jun 17, 2024
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How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
All 2 insured contracts are health coverage with KAISER FOUNDATION HEALTH PLAN, INC..
Reported premium across the insured contracts is $95,927, with $767 in disclosed broker commissions — about 0.8% of premium.
The most recent policy period ended in August, and the plan year ends August 31. Group contracts typically renew on that annual cycle.
WILLIS TOWERS WATSON US LLC is the broker of record on all 2 contracts.
At 41 participants this is a small group; Form 5500 is required once a welfare plan reaches 100 participants, or when it is funded through insurance contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 8 | Sep 1, 2023 | $84,958 | $705 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 1 | Sep 1, 2023 | $10,969 | $62 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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