Form 5500 · Employee benefit plan · PLEASANTON, CA
THE PERMANENTE MEDICAL GROUP, INC.
The filing calls this plan THE PERMANENTE MEDICAL GROUP, INC. SPECIAL WELFARE BENEFIT PLAN FOR RETIRED EMPLOYEES.
THE PERMANENTE MEDICAL GROUP, INC. of PLEASANTON, CA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Coverage is written through KAISER FOUNDATION HEALTH PLAN, INC. and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-2728480 · plan 608 · plan year 2025, filed Aug 21, 2026
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How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Health: KAISER FOUNDATION HEALTH PLAN, INC. covers 256 of 3,612 participants (7.1%) on Schedule A.
Dental: DELTA DENTAL PLAN OF CALIFORNIA covers 45 of 3,612 participants (1.2%) on Schedule A.
Vision: KAISER FOUNDATION HEALTH PLAN, INC. covers 256 of 3,612 participants (7.1%) on Schedule A.
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 and vision.
Reported premium is $1,289,747; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
No broker of record is named on the Schedule A. The contracts may be written directly with the carrier, or the broker fields were left blank on the filing.
Two carriers split the book: KAISER FOUNDATION HEALTH PLAN, INC. and DELTA DENTAL PLAN OF CALIFORNIA.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. | Health, Vision | 256 | Jan 1, 2026 | $1,251,886 | $0 |
| DELTA DENTAL PLAN OF CALIFORNIA | Dental | 45 | Jan 1, 2026 | $37,861 | $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.
Reported to OSHA
Reported to OSHA for 2025: 40,558 employees, 1,351 recordable cases, 2,455 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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