Form 5500 · Employee benefit plan · ROOSEVELT, UT
MOON LAKE ELECTRIC ASSOCIATION INC.
MOON LAKE ELECTRIC ASSOCIATION INC. of ROOSEVELT, UT files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is GBS BENEFITS. Coverage is written through SELECTHEALTH and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 87-0154903 · plan 501 · as of Aug 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SELECTHEALTH | Health | 361 | December | $1,693,087 | $84,654 |
| STANDARD INSURANCE COMPANY | Life, Disability | 112 | December | $124,280 | $12,145 |
| RELIANCE STANDARD | — | 56 | December | $15,346 | $3,069 |
| RELIANCE STANDARD | — | 38 | December | $12,314 | $2,463 |
| NATIONAL GUARDIAN LIFE INSURANCE COMPANY | Vision | 281 | December | $13,092 | $1,954 |
| AMERITAS LIFE INSURANCE COMPANY | Dental | 96 | December | $6,561 | $1,201 |
Questions
Who is MOON LAKE ELECTRIC ASSOCIATION INC.'s benefits broker?
Per its most recent Form 5500 Schedule A, MOON LAKE ELECTRIC ASSOCIATION INC.'s broker of record is GBS BENEFITS.
What insurance carrier does MOON LAKE ELECTRIC ASSOCIATION INC. use?
MOON LAKE ELECTRIC ASSOCIATION INC.'s benefit plan is written through SELECTHEALTH, among 6 disclosed carriers.
When does MOON LAKE ELECTRIC ASSOCIATION INC.'s group plan renew?
The most recent Schedule A policy period for MOON LAKE ELECTRIC ASSOCIATION INC. ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from MOON LAKE ELECTRIC ASSOCIATION INC.'s public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.