Form 5500 · Employee benefit plan · SANTA ROSA, CA
PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA
PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA of SANTA ROSA, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is KAREN HAIGH. Coverage is written through UNUM LIFE INSURANCE COMPANY OF AMERICA and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 88-1779768 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 308 | December | $122,535 |
| WESTERN HEALTH ADVANTAGE | Health | 425 | December | $121,011 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision | 286 | December | $56,652 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 117 | December | $10,949 |
| CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | Health | 238 | December | $0 |
Questions
Who is PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA's benefits broker?
Per its most recent Form 5500 Schedule A, PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA's broker of record is KAREN HAIGH.
What insurance carrier does PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA use?
PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA's benefit plan is written through UNUM LIFE INSURANCE COMPANY OF AMERICA, among 5 disclosed carriers.
When does PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA's group plan renew?
The most recent Schedule A policy period for PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.