# JACKSON FAMILY ENTERPRISES HEALTH CARE PLAN

Health and welfare plan sponsored by **JACKSON FAMILY ENTERPRISES**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | JACKSON FAMILY ENTERPRISES |
| EIN | 205780901 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | SANTA ROSA, CA |
| Industry | sports |
| Funding | mewa |
| Total premiums | $27.1M |
| Participants | 1,623 |
| Persons covered | 1,824 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| ANTHEM LIFE INSURANCE COMPANY | Health, Rx, HMO, PPO |
| KAISER PERMANENTE | Health, Rx, HMO |
| MODERN HEALTH ARIZONA, PLLC | Other |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (CIGNA) | Life, LTD, Other |
| VISION SERVICE PLAN (VSP) | Vision |
| HAWAII MEDICAL SERVICE ASSOCIATION | Health, Rx |
| HARTFORD LIFE AND ACCIDENT | Other |

## Brokers

| Broker | Placed with |
|---|---|
| LIBERTY COMPANY INSURANCE BROKERS | BLUE CROSS OF CALIFORNIA |
| ALLIANT INSURANCE SERVICES, INC. | BLUE CROSS OF CALIFORNIA |
| LIBERTY COMPANY INSURANCE BROKERS | KAISER FOUNDATION HEALTH PLAN, INC. |
| ALLIANT INSURANCE SERVICES, INC. | KAISER FOUNDATION HEALTH PLAN, INC. |
| LIBERTY COMPANY INSURANCE BROKERS | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| ALLIANT INSURANCE SERVICES, INC. | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| LIBERTY COMPANY INSURANCE BROKERS | HARTFORD FIRE INSURANCE COMPANY |

## About this data

- Source: public Form 5500 filings from the U.S. Department of Labor (EBSA), rebuilt on each DOL release.
- Full page (charts, history, peer benchmarks, fees, contacts): https://planoptica.com/welfare/205780901-501
- Cite as: PlanOptica, https://planoptica.com/welfare/205780901-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers