Form 5500 · Employee benefit plan · PLACERVILLE, CA
SHINGLE SPRINGS BAND OF MIWOK INDIANS
SHINGLE SPRINGS BAND OF MIWOK INDIANS of PLACERVILLE, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ACRISURE OF CALIFORNIA LLC. Coverage is written through BLUE CROSS OF CALIFORNIA and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 68-0165026 · plan 501 · as of Jul 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Commission |
|---|---|---|---|---|
| BLUE CROSS OF CALIFORNIA | Health | 329 | December | $458,288 |
| METROPOLITAN LIFE INSURANCE COMPANY | Dental, Vision, Life | 1,009 | December | $23,717 |
| GUARDIAN | — | 73 | December | $6,798 |
Questions
Who is SHINGLE SPRINGS BAND OF MIWOK INDIANS's benefits broker?
Per its most recent Form 5500 Schedule A, SHINGLE SPRINGS BAND OF MIWOK INDIANS's broker of record is ACRISURE OF CALIFORNIA LLC.
What insurance carrier does SHINGLE SPRINGS BAND OF MIWOK INDIANS use?
SHINGLE SPRINGS BAND OF MIWOK INDIANS's benefit plan is written through BLUE CROSS OF CALIFORNIA, among 3 disclosed carriers.
When does SHINGLE SPRINGS BAND OF MIWOK INDIANS's group plan renew?
The most recent Schedule A policy period for SHINGLE SPRINGS BAND OF MIWOK INDIANS ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from SHINGLE SPRINGS BAND OF MIWOK INDIANS's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.