| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY & BLUE CROSS CA | $117K | $0 | $117K | 2.75% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 900 NORTH SHORLIND BOULEVARD MOUNTAIN VIEW, CA 94043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | $481 | $24K | 8.37% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 900 NORTH SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | VISION SERVICE PLAN | $2K | — | $2K | 2.75% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INS ASSOC INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 32.71% |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY & BLUE CROSS CA | 275 | $5.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 364 | $25K |
| Vision | VISION SERVICE PLAN | 359 | $88K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 353 | $283K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 353 | $283K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 353 | $283K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY & BLUE CROSS CA | 275 | $5.1M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 353 | $283K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 364 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.