Form 5500 · Employee benefit plan · BETHESDA, MD
JIM COLEMAN AUTO
The filing calls this plan JIM COLEMAN AUTO HEALTH BENEFIT PLAN.
JIM COLEMAN AUTO of BETHESDA, MD is a 164-participant retail employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is WANADA BUSINESS SERVICES CORP. Coverage is written through KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC.. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 52-0677705 · plan 502 · plan year 2026, filed Aug 14, 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
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.
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
The filing discloses a single insured line, health, through KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC., covering 161 people.
Reported premium across the insured contracts is $899,256, with $55,232 in disclosed broker commissions — about 6.1% of premium.
The most recent policy period ended in February, and the plan year ends February 28. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | Health | 161 | Mar 1, 2026 | $899,256 | $55,232 |
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.
Reported to OSHA
Reported to OSHA for 2025: 74 employees, 6 recordable cases, 11 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
How this plan compares
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