Form 5500 · Employee benefit plan · SAN FRANCISCO, CA
SELF-HELP FOR THE ELDERLY
The filing calls this plan SELF-HELP FOR THE ELDERLY HEALTH & WELFARE PLAN.
SELF-HELP FOR THE ELDERLY of SAN FRANCISCO, CA is a 239-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is FILICE INSURANCE AGENCY. Coverage is written through CHINESE COMMUNITY HEALTH PLAN and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-1750717 · plan 501 · plan year 2025, filed Sep 3, 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 5 insured contracts covering health, dental and vision; the largest, with CHINESE COMMUNITY HEALTH PLAN, covers 142 people.
Reported premium across the insured contracts is $2,387,564, with $129,249 in disclosed broker commissions — about 5.4% 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 AGENCY is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including CHINESE COMMUNITY HEALTH PLAN, SUTTER HEALTH PLAN, AMERITAS LIFE INSURANCE CORP. and KAISER FOUNDATION HEALTH PLAN, INC.. CHINESE COMMUNITY HEALTH PLAN writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CHINESE COMMUNITY HEALTH PLAN | Health | 142 | Jan 1, 2026 | $1,080,331 | $54,017 |
| SUTTER HEALTH PLAN | Health | 95 | Jan 1, 2026 | $912,015 | $45,601 |
| AMERITAS LIFE INSURANCE CORP. | Dental, Vision | 242 | Jan 1, 2026 | $201,717 | $20,172 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 17 | Jan 1, 2026 | $190,201 | $9,459 |
| CLAREMONT EAP | — | 95 | Jan 1, 2026 | $3,300 | $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.
Other plans filed by this employer
How this plan compares
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