| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $100K | $7K | $106K | 11.15% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | STARMOUNT LIFE INSURANCE COMPANY | $8K | $1K | $9K | 5.75% |
| 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 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $1K | $16K | 10.75% |
| 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 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | $1 | $5K | 4.61% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM INSURANCE COMPANY | $2K | $177 | $3K | 10.75% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $13K | — | $13K | 56.42% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $147 | $2K | 10.75% |
| 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 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM INSURANCE COMPANY | $2K | $200 | $2K | 11.03% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC. | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 TPA | Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Float revenue; Participant communication Service code 12 | — | $66K |
| CIGNA | Non-monetary compensation; Real estate brokerage; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication; Named fiduciary Service code 12 | — | $0 |
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 | 235 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 351 | $1.1M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 218 | $151K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 351 | $23K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 236 | $166K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 236 | $166K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 236 | $147K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 351 | $130K |
| Other(2 contracts, 2 carriers) | UNUM INSURANCE COMPANY | 146 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.