# AMPLA HEALTH CONSOLIDATED WELFARE BENEFITS PLAN

DOL Acknowledgment ID: 20250211180748NAL0010831763001
Plan number: 509
Plan effective date: 2003-09-01
Form year: 2024

## Sponsor

- Name: AMPLA HEALTH
- EIN: 942210447
- Address: 935 MARKET STREET, YUBA CITY, CA, 95991
- Phone: 5306744261
- Business code: 621498

## Administrator

- Name: —
- EIN: —
- Phone: —

## Participation

- Total participants (beginning of year): 504
- Active participants: 525
- Retired / separated receiving benefits: 0
- Beneficiaries receiving benefits: —
- Participants with account balance: —

## Plan types

### Pension benefits
—

### Welfare benefits
- 4A4B4D4E4H4L: 4A4B4D4E4H4L

## Funding & flags

- Funding sources: Insurance contracts, General assets
- Collective bargaining: No
- Amended filing: Yes
- Final filing: No

## Source

- DOL EFAST2 filing lookup: https://efast.dol.gov/5500Search/PlanFilings.aspx?AckID=20250211180748NAL0010831763001
- IRS BMF (sponsor): https://api.morvs.ai/nonprofit/942210447