# CHEVRON STATIONS INC. GROUP INSURANCE PLAN

Health and welfare plan sponsored by **CHEVRON STATIONS INC.**. Form 5500 filing for plan year 2025.

| Field | Value |
|---|---|
| Sponsor | CHEVRON STATIONS INC. |
| EIN | 840618607 |
| Plan number | 697 |
| Plan year | 2025 |
| Location | SAN RAMON, CA |
| Industry | individual & family services |
| Funding | fully insured |
| Total premiums | $12.9M |
| Participants | 3,137 |
| Persons covered | 3,313 |

## Insurance carriers (Schedule A)

| Carrier | Coverage |
|---|---|
| KAISER PERMANENTE | Health, HMO, Rx |
| BLUE SHIELD OF CALIFORNIA | Health, Rx, HMO |
| HARTFORD LIFE AND ACCIDENT | Life, LTD, Indemnity, Other |
| AETNA LIFE INSURANCE COMPANY | Dental |
| VISION SERVICE PLAN (VSP) | Vision |
| CURALINC HEALTHCARE | Other |
| METLIFE LEGAL PLANS | Other |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY | Health, Indemnity |
| ADVANCE MEDICAL, INC. | Other |

## Brokers

| Broker | Placed with |
|---|---|
| MERCER HEALTH AND BENEFITS, LLC | KAISER FOUNDATION HEALTH PLAN INC |
| MERCER HEALTH AND BENEFITS, LLC | BLUE SHIELD OF CALIFORNIA |
| MERCER HEALTH AND BENEFITS, LLC | HARTFORD LIFE AND ACCIDENT |
| MERCER HEALTH AND BENEFITS, LLC | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST |
| MERCER HEALTH AND BENEFITS, LLC | AETNA LIFE INSURANCE COMPANY |
| MERCER HEALTH AND BENEFITS, LLC | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON |
| MERCER HEALTH AND BENEFITS, LLC | VISION SERVICE PLAN |
| MERCER HEALTH AND BENEFITS, LLC | METLIFE LEGAL PLANS |
| MERCER HEALTH AND BENEFITS, LLC | AMERICAN HERITAGE LIFE 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/840618607-697
- Cite as: PlanOptica, https://planoptica.com/welfare/840618607-697
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