# BAY 101 EMPLOYEE WELFARE PLAN

Health and welfare plan sponsored by **BAY 101** (dba BAY 101). Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | BAY 101 |
| EIN | 770187274 |
| Plan number | 501 |
| Plan year | 2025 |
| Location | SAN JOSE, CA |
| Industry | Arts, Entertainment, and Recreation |
| Funding | fully insured |
| Total premiums | $4.2M |
| Participants | 345 |
| Persons covered | 423 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| KAISER PERMANENTE | Health |
| SUTTER HEALTH PLAN | Health, Rx, HMO |
| EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, PPO |
| METLIFE LEGAL PLANS | Dental, Life, STD, LTD, Other |
| KEPRO | Other |
| SOLSTICE BENEFITS, INC | Dental |
| SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | Dental, HMO |

## Brokers

| Broker | Placed with |
|---|---|
| ACRISURE LLC | KAISER FOUNDATION HEALTH PLAN INC |
| PROGRESSIVE BENEFIT GROUP | KAISER FOUNDATION HEALTH PLAN INC |
| PBG PROFESSIONAL INSURANCE SERVICES | SUTTER HEALTH PLAN |
| ACRISURE LLC | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA |
| ACRISURE LLC | METROPOLITAN LIFE INSURANCE COMPANY |
| GROUP BENEFITS LTD | METROPOLITAN LIFE INSURANCE COMPANY |
| ACRISURE LLC | SAFEGAURD HEALTH PLANS, INC A CALIFORNIA CORPORATION |
| GROUP BENEFITS LTD | SAFEGAURD HEALTH PLANS, INC A CALIFORNIA CORPORATION |

## 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/770187274-501
- Cite as: PlanOptica, https://planoptica.com/welfare/770187274-501
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