Form 5500 · Employee benefit plan · ATLANTA, GA
DELTA AIR LINES, INC.
The filing calls this plan DELTA FAMILY-CARE MEDICAL PLAN.
DELTA AIR LINES, INC. of ATLANTA, GA is a 7,070-participant transportation and logistics employer whose group benefits are disclosed in its annual Form 5500 filing. Coverage is written through BLUE CROSS BLUE SHIELD OF HAWAII. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 58-0218548 · plan 501 · plan year 2024, filed Apr 29, 2025
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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
Health: BLUE CROSS BLUE SHIELD OF HAWAII covers 1 of 7,070 participants (under 0.1%) on Schedule A.
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.
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
The filing discloses a single insured line, health, through BLUE CROSS BLUE SHIELD OF HAWAII.
The filing declares health and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium is $20,940; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends June 30. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF HAWAII | Health | 1 | Jan 1, 2024 | $20,940 | $0 |
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
Named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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