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Sponsor portfolioWelfare / HealthEIN 81-4843379

TWIC

d/b/a FORMA
47000 WARM SPRINGS BOULEVARD · FREMONT, CA 94539
8668399238
Plans filed
1
Years active
2023–2025
Industry
NAICS 52
Latest filing
2025
Total premiums (latest)
$1.6M
No prior year
Persons covered
143
No prior year
Total participants
0
No prior year
Plans filed
1
No prior year

Plans under this sponsor

1 plan
Plan #501$1.6M
FORMA EMPLOYEE BENEFITS PLAN
Fully insured143 covered·3 carriers
Primary: BLUE CROSS OF CALIFORNIA

Coverage overview

Aggregate, latest year
Benefit typePremiumShareDistribution
Health$1.5M24.2%
Prescription drug$1.5M24.2%
Dental$1.4M22.7%
Vision$1.4M22.7%
Life$94K1.5%
Short-term disability$94K1.5%
Long-term disability$94K1.5%
Other$94K1.5%

Carrier overview

3 carriers · all plans
CarrierCoverageTotal premiumSharePlansContractsCovered
BLUE CROSS OF CALIFORNIA
EIN 953760980
HRxDV
$1.4M88.4%11143
ANTHEM LIFE INSURANCE COMPANY
EIN 520913817
LSTDLTDOth
$94K6.0%11136
KAISER FOUNDATION HEALTH PLAN INC
EIN 941340523
HRx
$88K5.6%1111

Broker overview

2 brokers · all plans
BrokerLocCarriersCommissionsFeesTotal compSharePlans
ADVOCATE, INC.NEW YORK, NYKAISER FOUNDATION HEALTH PLAN, INC., BLUE CROSS OF CALIFORNIA$79K$1K$80K89.3%1
NAVA BENEFITSNEW YORK, NYANTHEM LIFE INSURANCE COMPANY$10K$0$10K10.7%1

History & trajectory

3 years · all plans
Total premiums
Summed across all plans for this sponsor.
Persons covered
EOY headcount summed across all plans.
Carrier mix
Premium by top carriers, summed across plans.
Broker compensation
Comp by top brokers, summed across plans.

Policy details

Latest year, by plan
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