# FORMAGRID DBA AIRTABLE INC HEALTH AND WELFARE PLAN

Health and welfare plan sponsored by **FORMAGRID, INC.** (dba AIRTABLE INC). Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | FORMAGRID, INC. |
| EIN | 462070030 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | SAN FRANCISCO, CA |
| Industry | Professional, Scientific, and Technical Services |
| Funding | fully insured |
| Total premiums | $14.2M |
| Participants | 608 |
| Persons covered | 1,282 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| AETNA LIFE INSURANCE COMPANY | Health, Dental |
| KAISER PERMANENTE | Health, Rx, HMO |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Life, STD, LTD, Other |
| MODERN HEALTH ARIZONA, PLLC | Other |
| VISION SERVICE PLAN (VSP) | Vision |

## Brokers

| Broker | Placed with |
|---|---|
| DIGITAL INSURANCE LLC | AETNA LIFE INSURANCE CO. |
| DIGITAL INSURANCE LLC | KAISER FOUNDATION HEALTH PLAN INC. |
| DIGITAL INSURANCE LLC | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA |
| DIGITAL INSURANCE LLC | VISION SERVICE PLAN |

## 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/462070030-501
- Cite as: PlanOptica, https://planoptica.com/welfare/462070030-501
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