Form 5500 · Employee benefit plan · ARLATA, CA
UNITED INDIAN HEALTH SERVICES
The filing calls this plan UNITED INDIAN HEALTH SERVICES WELFARE BENEFITS PLAN.
Public Form 5500 records show how UNITED INDIAN HEALTH SERVICES of ARLATA, CA, a health care and social assistance employer, structures its employee benefits. Its broker of record is VERUS INSURANCE SERVICES, LLC. Coverage is written through LIFE INSURANCE COMPANY OF NORTH AMERICA. The plan's most recent policy period ended in January.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 23-7088205 · plan 501 · plan year 2025, filed Jun 17, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
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 3 insured contracts covering life and disability; the largest, with LIFE INSURANCE COMPANY OF NORTH AMERICA, covers 286 people.
The filing declares life, disability, health, dental and vision. Health, dental and vision appear with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $107,695, with $11,445 in disclosed broker commissions — about 11% of premium.
The most recent policy period ended in January, and the plan year ends November 30. Group contracts typically renew on that annual cycle.
VERUS INSURANCE SERVICES, LLC is the broker of record on all 3 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life | 286 | Feb 1, 2025 | $63,501 | $6,732 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 286 | Feb 1, 2025 | $35,723 | $3,809 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | — | 286 | Feb 1, 2025 | $8,471 | $904 |
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
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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