Form 5500 · Employee benefit plan · SAN FRANCISCO, CA
BYER CALIFORNIA
The filing calls this plan BYER CALIFORNIA AND ALFRED PAQUETTE DIVISION WELFARE PLAN.
BYER CALIFORNIA of SAN FRANCISCO, CA insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is WILLIS TOWERS WATSON INS SVCS WEST. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-1582944 · plan 501 · plan year 2024, filed Jun 18, 2025
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits.
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.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
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 9 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 84 people.
Reported premium across the insured contracts is $157,976, with $9,687 in disclosed broker commissions — about 6.1% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
WILLIS TOWERS WATSON INS SVCS WEST is the broker of record on 7 of the 9 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., CIGNA HEALTH AND LIFE INSURANCE COMPANY, CIGNA HEALTHCARE OF CALIFORNIA and LIFE INSURANCE COMPANY OF NORTH AMERICA. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTHCARE OF CALIFORNIA | Health | 158 | Jan 1, 2025 | $13,396 | $4,067 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 84 | Jan 1, 2025 | $77,474 | $2,182 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 35 | Jan 1, 2025 | $36,966 | $1,843 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life | 0 | Jan 1, 2025 | $6,392 | $767 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 0 | Jan 1, 2025 | $3,188 | $383 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 9 | Jan 1, 2025 | $16,534 | $248 |
| DELTA DENTAL OF CALIFORNIA | Health, Dental | 121 | Jan 1, 2025 | $1,672 | $167 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | — | 0 | Jan 1, 2025 | $247 | $30 |
| VISION SERVICE PLAN | Vision | 144 | Jan 1, 2025 | $2,107 | $0 |
Premium and claims on these contracts
CIGNA HEALTHCARE OF CALIFORNIA, contract 2499336/3209628. For the contract year on this filing, the carrier reported $13,396 in premium earned and $3,640 in claims incurred. Dividing one by the other gives 27%.
CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 2499336/3209628. For the contract year on this filing, the carrier reported $2,469 in premium earned and $-3,117 in claims incurred. Dividing one by the other gives -126%.
- CIGNA HEALTHCARE OF CALIFORNIA, contract 2499336/3209628 reported $13,396 in retention.
- CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 2499336/3209628 reported $2,781 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.
Other plans filed by this employer
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