| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | P.O. BOX 1414 MINNEAPOLIS, MN 55480 | KAISER FOUNDATION HEALTH PLAN, INC. | $29K | — | $29K | 2.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 901 MARQUETTE AVE SUITE 1800 MINNEAPOLIS, MN 33402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $24K | — | $24K | 8.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | — | $15K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $3K | $3K | 0.94% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 901 MARQUETTE AVE SUITE 1800 MINNEAPOLIS, MN 33402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $23K | — | $23K | 8.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14K | — | $14K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $3K | $3K | 0.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 901 MARQUETTE AVE SUITE 1800 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14K | — | $14K | 8.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 2.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 901 MARQUETTE AVE SUITE 1800 MINNEAPOLIS, MN 33402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 20.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $420 | $420 | 0.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 901 MARQUETTE AVE SUITE 1800 MINNEAPOLIS, MN 33402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 20.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $463 | $463 | 1.06% |
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 | 1,251 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 173 | $1.0M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 844 | $86K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,251 | $282K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,052 | $297K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 397 | $171K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 173 | $1.0M |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,275 | $402K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,275 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.