| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | BLUE CROSS OF CALIFORNIA | $115K | — | $115K | 4.41% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $3K | $21K | 11.90% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC. | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | STARMOUNT LIFE INSURANCE COMPANY | $9K | $3K | $12K | 6.89% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E. 96TH STREET SET 250 INDIANAPOLIS, IN 46240 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | $2 | $4K | 4.33% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $511 | $3K | 11.90% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM INSURANCE COMPANY | $3K | $486 | $3K | 11.90% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM INSURANCE COMPANY | $2K | $451 | $3K | 11.92% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC. | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 371 | $2.7M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 252 | $176K |
| Vision | BLUE CROSS OF CALIFORNIA | 371 | $2.6M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $204K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $200K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $177K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 371 | $2.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 180 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 371 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.