Plan5500

Table Mountain Rancheria Welfare Benefit Plan — Form 5500 plan (Table Mountain Rancheria Band Of Indians)

Plain-English plan summary

According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, Table Mountain Rancheria Welfare Benefit Plan is a benefit plan reported by Table Mountain Rancheria Band Of Indians under EIN 77-0212451 and plan number 501. The latest loaded filing year is 2023. The filing reports 998 participants and not reported in the loaded dataset in end-of-year plan assets, where available in the loaded dataset.

Key reported metrics

Plan sponsor
Table Mountain Rancheria Band Of Indians
EIN
77-0212451
Plan number
501
Plan type
2
Location
Friant, CA
Latest filing year
2023
Participants
998
End-of-year plan assets
not reported in the loaded dataset

Form 5500 filing history

Filings loaded for this plan
Filing yearParticipantsSchedulesFiling
2023998C20240708074936NAL0025967234001

Reported financial statement

This plan is loaded, but Schedule H / I financial-statement detail is not present for it in the current loaded dataset.

Service provider compensation (Schedule C)

Reported service provider compensation
ProviderServiceDirect comp.Indirect comp.Year
AdvantekTPA$297,906not reported in the loaded dataset2023
Anthem Blue Cross Life & HealthPPO NETWORK$268,703not reported in the loaded dataset2023
Blue Cross Of CaliforniaPPO PANEL FEES$219,316not reported in the loaded dataset2023
MultiplanPPO REPRICING$41,872not reported in the loaded dataset2023
Rxbenefits, Inc.TPA$12,799not reported in the loaded dataset2023

Related Form 5500 pages