Form 5500 · Employee benefit plan · PETALUMA, CA
HYDROPOINT DATA SYSTEMS, INC.
HYDROPOINT DATA SYSTEMS, INC. of PETALUMA, CA insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is ACRISURE WEST INSURANCE SERVICES,. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 32-0034429 · plan 501 · plan year 2025, filed Sep 24, 2026
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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: 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 87 people.
Reported premium across the insured contracts is $1,874,542, with $231,940 in disclosed broker commissions — about 12% 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.
ACRISURE WEST INSURANCE SERVICES, is the broker of record on 1 of the 7 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., CIGNA HEALTH AND LIFE INSURANCE COMPANY, AMERITAS LIFE INSURANCE CORP. and THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. KAISER FOUNDATION HEALTH PLAN, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 163 | Jan 1, 2026 | $809,288 | $149,116 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 87 | Jan 1, 2026 | $819,360 | $49,161 |
| AMERITAS LIFE INSURANCE CORP. | Dental, Vision | 319 | Jan 1, 2026 | $145,169 | $21,776 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 149 | Jan 1, 2026 | $41,937 | $4,949 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 59 | Jan 1, 2026 | $25,293 | $2,985 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 149 | Jan 1, 2026 | $20,122 | $2,375 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 149 | Jan 1, 2026 | $13,373 | $1,578 |
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.
Reported to OSHA
Reported to OSHA for 2025: 142 employees, 0 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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