Form 5500 · Employee benefit plan · LYNCHBURG, VA
DELTA STAR, INC.
The filing calls this plan DELTA STAR, INC. GROUP WELFARE PLAN.
DELTA STAR, INC. of LYNCHBURG, VA insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is MARSH & MACLENNAN AGENCY LLC. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 3 other carriers. The plan's most recent policy period ended in June.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 25-1586168 · plan 506 · plan year 2025, filed Jan 27, 2026
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167 other employer plans in Virginia have policy years ending in June. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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: 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 5 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 577 people.
Reported premium across the insured contracts is $6,914,140, with $316,357 in disclosed broker commissions — about 4.6% 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.
MARSH & MACLENNAN AGENCY LLC is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., SUN LIFE ASSURANCE COMPANY OF CANADA, DELTA DENTAL OF CALIFORNIA and AMERITAS LIFE INSURANCE CORP.. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 577 | Jul 1, 2025 | $5,801,841 | $168,064 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life, Disability | 1,012 | Jul 1, 2025 | $703,313 | $121,448 |
| AMERITAS LIFE INSURANCE CORP. | Vision | 1,555 | Jul 1, 2025 | $127,925 | $12,792 |
| DELTA DENTAL OF CALIFORNIA | Dental | 450 | Jul 1, 2025 | $254,781 | $12,739 |
| DELTA DENTAL OF CALIFORNIA | Dental | 115 | Jul 1, 2025 | $26,280 | $1,314 |
Premium and claims on this contract
DELTA DENTAL OF CALIFORNIA, contract 00809. For the contract year on this filing, the carrier reported $254,781 in premium earned and $162,157 in claims incurred. Dividing one by the other gives 64%.
- DELTA DENTAL OF CALIFORNIA, contract 00809 reported $74,527 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Reported to OSHA
Reported to OSHA for 2025: 980 employees, 47 recordable cases, 412 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
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