Form 5500 · Employee benefit plan · SAN RAMON, CA
DONOR NETWORK WEST
The filing calls this plan DONOR NETWORK WEST HEALTH AND WELFARE PLAN.
DONOR NETWORK WEST of SAN RAMON, CA spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is FILICE INSURANCE SERVICES LLC. 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 94-3062436 · plan 501 · plan year 2024, filed Jul 21, 2025
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5,257 other employer plans in California have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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, 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.
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 7 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 350 people.
Reported premium across the insured contracts is $5,270,035, with $259,744 in disclosed broker commissions — about 4.9% 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.
FILICE INSURANCE SERVICES LLC is the broker of record on 3 of the 7 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., SUTTER HEALTH PLAN, HOMETOWN HEALTH and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 350 | Jan 1, 2025 | $3,438,201 | $140,818 |
| SUTTER HEALTH PLAN | Health | 93 | Jan 1, 2025 | $649,031 | $32,451 |
| RELIASTAR LIFE INSURANCE COMPANY | Life, Disability | 357 | Jan 1, 2025 | $204,718 | $29,742 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision | 316 | Jan 1, 2025 | $407,493 | $25,415 |
| HOMETOWN HEALTH | Health | 25 | Jan 1, 2025 | $461,749 | $25,396 |
| HOMETOWN HEALTH | Health | 10 | Jan 1, 2025 | $107,681 | $5,922 |
| VOYA RETIREMENT INSURANCE AND ANNUITY COMPANY | — | 357 | Jan 1, 2025 | $1,162 | $0 |
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. The service providers are named on Schedule C of this filing. We publish company names only.
Other plans filed by this employer
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