Form 5500 · Employee benefit plan · LOS ANGELES, CA
THE 170 GROUP INSURANCE BENEFITS TRUST
THE 170 GROUP INSURANCE BENEFITS TRUST of LOS ANGELES, CA spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is NONE. Coverage is written through KAISER PERMANENTE HEALTH PLAN INC and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 95-3136353 · plan 501 · plan year 2025, filed Apr 15, 2026
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
How this plan is funded
Fully insured as reported
The plan's own financial statement reports paying insurance carriers about what the insurance contracts report in premium.
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.
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 4 insured contracts covering health, dental, vision and life; the largest, with KAISER PERMANENTE HEALTH PLAN INC, covers 1,358 people.
Reported premium is $9,236,292; the filing discloses no broker commission on these contracts.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in June. The plan is on a split renewal cycle.
NONE is the broker of record on 3 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including KAISER PERMANENTE HEALTH PLAN INC, UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC., VISION SERVICE PLAN and UNITEDHEALTHCARE INSURANCE COMPANY. KAISER PERMANENTE HEALTH PLAN INC writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER PERMANENTE HEALTH PLAN INC | Health | 1,358 | Jan 1, 2025 | $8,874,778 | $0 |
| UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | Dental | 1,421 | Jul 1, 2025 | $246,906 | $0 |
| VISION SERVICE PLAN | Vision | 697 | Jul 1, 2025 | $57,729 | $0 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Life | 682 | Jul 1, 2025 | $56,879 | $0 |
Premium and claims on this contract
UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC., contract 740204-000,001. For the contract year on this filing, the carrier reported $246,906 in premium earned and $49,133 in claims incurred. Dividing one by the other gives 20%.
- UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC., contract 740204-000,001 reported $54,122 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
Named on Schedule C of this filing. We publish company names only.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
How this plan compares
Subscribers see how this compares with similar plans in California. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in California — largest plans, brokers, carriers and renewal months.