Form 5500 · Employee benefit plan · RIVERSIDE, CA
MOSS BROS.
The filing calls this plan MOSS BROS. HEALTH AND WELFARE PLAN.
MOSS BROS. of RIVERSIDE, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is SULLIVAN CURTIS MONROE INS. SVCS.. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 5 other carriers. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-2803540 · plan 501 · plan year 2025, filed Sep 24, 2025
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305 other employer plans in California have policy years ending in March. 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 8 insured contracts covering health, dental, vision and life; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 413 people.
Reported premium across the insured contracts is $3,416,635, with $145,123 in disclosed broker commissions — about 4.2% of premium.
The most recent policy period ended in March, and the plan year ends March 31. Group contracts typically renew on that annual cycle.
SULLIVAN CURTIS MONROE INS. SVCS. is the broker of record on all 8 contracts.
6 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., CALIFORNIA PHYSICIANS SERVICE, UNITED CONCORDIA INSURANCE COMPANY and UNITED OF OMAHA LIFE INSURANCE COMPANY. 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 | 413 | Apr 1, 2025 | $3,035,481 | $114,829 |
| UNITED CONCORDIA INSURANCE COMPANY | Dental | 323 | Apr 1, 2025 | $120,175 | $11,806 |
| CALIFORNIA PHYSICIANS SERVICE | Health | 19 | Apr 1, 2025 | $150,776 | $7,539 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 161 | Apr 1, 2025 | $56,000 | $5,600 |
| UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | Dental | 207 | Apr 1, 2025 | $27,755 | $2,704 |
| VISION PLAN OF AMERICA | Vision | 118 | Apr 1, 2025 | $13,947 | $1,395 |
| VISION PLAN OF AMERICA | Vision | 78 | Apr 1, 2025 | $9,327 | $933 |
| VISION PLAN OF AMERICA | Vision | 28 | Apr 1, 2025 | $3,174 | $317 |
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.
How this plan compares
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Renewal calendar
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