Form 5500 · Employee benefit plan · SAN JOSE, CA
SAN JOSE SHARKS, LLC
The filing calls this plan SAN JOSE SHARKS, LLC WELFARE BENEFITS PLAN.
SAN JOSE SHARKS, LLC of SAN JOSE, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is EXPERTQUOTE, INC.. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 7 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 73-1638357 · plan 501 · plan year 2024, filed Jun 9, 2025
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
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 9 insured contracts covering health, dental, vision, life and disability; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 324 people.
Reported premium across the insured contracts is $5,372,742, with $269,040 in disclosed broker commissions — about 5% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in March. The plan is on a split renewal cycle.
EXPERTQUOTE, INC. is the broker of record on 7 of the 9 contracts; the rest name a different broker or none.
8 carriers appear on the filing, including KAISER FOUNDATION HEALTH PLAN, INC., BLUE CROSS OF CALIFORNIA, DELTA DENTAL OF CALIFORNIA and STANDARD INSURANCE COMPANY. 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 | 324 | Jan 1, 2025 | $3,129,521 | $146,992 |
| BLUE CROSS OF CALIFORNIA | Health | 85 | Jan 1, 2025 | $1,771,082 | $90,581 |
| DELTA DENTAL OF CALIFORNIA | Dental | 158 | Jan 1, 2025 | $225,473 | $11,273 |
| STANDARD INSURANCE COMPANY | Life, Disability | 255 | Jan 1, 2025 | $137,098 | $8,379 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | — | 254 | Jan 1, 2025 | $38,452 | $7,690 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | Vision, Life, Disability | 105 | Jan 1, 2025 | $37,894 | $1,938 |
| TRANSAMERICA LIFE INSURANCE COMPANY | Life | 15 | Jan 1, 2025 | $8,334 | $1,692 |
| DELTA DENTAL OF CALIFORNIA | Dental | 35 | Jan 1, 2025 | $10,045 | $495 |
| ANTHEM LIFE INSURANCE COMPANY | Life, Disability | 241 | Apr 1, 2024 | $14,843 | $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. We publish company names only.
Other plans filed by this employer
How this plan compares
Subscribers see how this compares with similar plans in California. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
More employer plans in California — largest plans, brokers, carriers and renewal months.