Form 5500 · Employee benefit plan · MOORPARK, CA
KRETEK INTERNATIONAL, INC.
The filing calls this plan KRETEK INTERNATIONAL, INC. BENEFIT PLAN.
Public Form 5500 records show how KRETEK INTERNATIONAL, INC. of MOORPARK, CA, a other services employer, structures its employee benefits. Its broker of record is BENEFITS AMERICA INSURANCE SERVICES. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 1 other carrier. The plan's most recent policy period ended in February.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 77-0013041 · plan 501 · plan year 2025, filed Dec 15, 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: 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.
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 2 insured contracts covering health, dental, vision, life and disability.
Reported premium across the insured contracts is $475,730, with $39,182 in disclosed broker commissions — about 8.2% 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.
BENEFITS AMERICA INSURANCE SERVICES is the broker of record on all 2 contracts.
Two carriers split the book: KAISER FOUNDATION HEALTH PLAN, INC. and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, Life, Disability | 163 | Mar 1, 2025 | $188,752 | $24,955 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 34 | Mar 1, 2025 | $286,978 | $14,227 |
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.
Other plans filed by this employer
How this plan compares
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