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Form 5500 · Employee benefit plan · PLEASANTON, CA

THE PERMANENTE MEDICAL GROUP, INC.

The filing calls this plan MEDICAL BENEFITS PLAN FOR RETIRED PHYSICIANS AND SALARIED EMPLOYEES OF THE PERMANENTE MEDICAL GROUP, INC.

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.

Benefits broker of record
Not disclosed
Policy year ends
Decemberas filed for plan year 2024

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 94-2728480 · plan 523 · plan year 2024, filed Oct 14, 2025

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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.

All participants at the start of the year
215
Active at start of year
0
Active at end of year
0
Disclosed commissions
$0
Typical renewal
January 1

Benefits declared on this filing

Healthinsured — KAISER FOUNDATION HEALTH PLAN, INC.58 of 215 participants (27%)
Dentalinsured — DELTA DENTAL PLAN OF CALIFORNIA91 of 215 participants (42%)
Visioninsured — KAISER FOUNDATION HEALTH PLAN, INC.58 of 215 participants (27%)
Lifedeclared under plan 550
Disabilitydeclared under plan 550

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; the largest, with KAISER FOUNDATION HEALTH PLAN, INC., covers 58 people.

Reported premium is $738,600; 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

CarrierBenefitsCoveredRenewsPremiumCommission
KAISER FOUNDATION HEALTH PLAN, INC.Health, Vision58Jan 1, 2025$680,935$0
DELTA DENTAL PLAN OF CALIFORNIADental91Jan 1, 2025$57,665$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.

See the filing at the Department of Labor

Administrator and service providers

MOSS ADAMS LLP
Accounting and audit · EIN 91-0189318
$9,550
paid directly by the plan
STATE STREET BANK AND TRUST COMPANY
TRUSTEE · EIN 04-1867445
$6,586
paid directly by the plan

Named on Schedule C of this filing. We publish company names only.

Reported to OSHA

Reported to OSHA for 2025: 40,558 employees, 1,351 recordable cases, 2,455 days away from work.

EmployeesThe company's own average for the year
40,558
Hours worked
58,200,050
Recordable cases
1,351
Days away from work
2,455
Establishments filed under this EIN
28

Source: OSHA Injury Tracking Application establishment data, 2025.

Money the plan held and paid out

Plan assets at year end
$1,960,022
Paid out in benefits
$1,064,059
Paid to insurance carriersSchedule H, line 2e(2)
$738,600
Independent accountantEIN 13-5381590
BDO USA, P.C.
Accountant's opinion (Schedule H, line 3a)
Unmodified
Audit fee
$9,550

Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H

These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.

Other plans filed by this employer

How this plan compares

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