Form 5500 · Employee benefit plan · LOS ANGELES, CA
CITIZENS OF THE WORLD CHARTER SCHOOLS - LOS ANGELES
The filing calls this plan CITIZENS OF THE WORLD CHARTER SCHOOLS - LOS ANGELES HEALTH & WELFARE PLAN.
CITIZENS OF THE WORLD CHARTER SCHOOLS - LOS ANGELES of LOS ANGELES, CA insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is MELISSA A CERNY. Coverage is written through CALIFORNIACHOICE and 4 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-3532127 · plan 502 · plan year 2025, filed Dec 19, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits, other welfare.
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
Schedule A lists 12 insured contracts covering health, dental, vision, life and disability; the largest, with CALIFORNIACHOICE, covers 227 people.
Reported premium across the insured contracts is $2,610,455, with $185,233 in disclosed broker commissions — about 7.1% of premium.
The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
MELISSA A CERNY is the broker of record on 1 of the 12 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including CALIFORNIACHOICE, DELTA DENTAL OF CALIFORNIA, EYEMED VISION CARE and THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. CALIFORNIACHOICE writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CALIFORNIACHOICE | Health | 227 | Jul 1, 2025 | $2,364,008 | $160,043 |
| DELTA DENTAL OF CALIFORNIA | Dental | 299 | Jul 1, 2025 | $132,973 | $12,193 |
| EYEMED VISION CARE | Vision | 289 | Jul 1, 2025 | $27,095 | $2,942 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | 116 | Jul 1, 2025 | $12,481 | $2,155 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | 103 | Jul 1, 2025 | $11,392 | $1,709 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 80 | Jul 1, 2025 | $16,415 | $1,642 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 133 | Jul 1, 2025 | $10,330 | $1,033 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | 133 | Jul 1, 2025 | $10,330 | $1,033 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 282 | Jul 1, 2025 | $9,175 | $918 |
| HEALTH AND HUMAN RESOURCE CENTER | — | 318 | Jul 1, 2025 | $6,907 | $691 |
| DELTA DENTAL OF CALIFORNIA | Health, Dental | 60 | Jul 1, 2025 | $7,482 | $687 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 132 | Jul 1, 2025 | $1,867 | $187 |
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.
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