# PREMISE DATA EMPLOYEE BENEFITS PLAN

Health and welfare plan sponsored by **PREMISE DATA CORPORATION**. Form 5500 filing for plan year 2024.

| Field | Value |
|---|---|
| Sponsor | PREMISE DATA CORPORATION |
| EIN | 455294131 |
| Plan number | 501 |
| Plan year | 2024 |
| Location | SAN FRANCISCO, CA |
| Industry | Professional, Scientific, and Technical Services |
| Funding | fully insured |
| Total premiums | $1.9M |
| Participants | 60 |
| Persons covered | 175 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Health, Rx, HMO, PPO, Life, STD, LTD, Other |
| KAISER PERMANENTE | Health, Rx, HMO |
| DELTA DENTAL OF CALIFORNIA | Dental |
| VISION SERVICE PLAN (VSP) | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| WOODRUFF-SAWYER & CO | UNITEDHEALTHCARE INSURANCE COMPANY |
| SEQUOIA BENEFITS & INS SVCS LLC | UNITEDHEALTHCARE INSURANCE COMPANY |
| WOODRUFF-SAWYER & CO | DELTA DENTAL OF CALIFORNIA |
| SEQUOIA BENEFITS & INS SVCS LLC | DELTA DENTAL OF CALIFORNIA |
| WOODRUFF-SAWYER & CO | KAISER FOUNDATION HEALTH PLAN INC. |
| SEQUOIA BENEFITS & INS SVCS LLC | KAISER FOUNDATION HEALTH PLAN INC. |
| WOODRUFF-SAWYER & CO | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
| SEQUOIA BENEFITS & INS SVCS LLC | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
| WOODRUFF-SAWYER & CO | VISION SERVICE PLAN |
| SEQUOIA BENEFITS & INS SVCS LLC | VISION SERVICE PLAN |
| WOODRUFF-SAWYER & CO | KAISER FOUNDATION HEALTH PLAN INC HAWAII |

## 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/455294131-501
- Cite as: PlanOptica, https://planoptica.com/welfare/455294131-501
- More: https://planoptica.com/llms.txt · API waitlist: https://planoptica.com/developers