| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 5847 SAN FELIPE SUITE 2750 HOUSTON, TX 77057 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $33K | — | $33K | 2.08% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | — | $1K | $1K | 0.31% |
| MAPFRE INSURANCE AGENCY3 | PO BOX 70333 SAN JUAN, PR 00936 | MAPFRE LIFE INSURANCE COMPANY | $6K | — | $6K | 1.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA EIN 06-6033492 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $12.1M |
| ADP EIN 61-1169763 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $137K |
| BANK OF NY MELLON ASSET SERVICING EIN 13-5160382 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $12K |
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 | 23,193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 636 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 23,829 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(34 contracts, 17 carriers) | KAISER FOUNDATION HEALTH PLANS OF SOUTHERN CALIFORNIA | 1,014 | $20.1M |
| Dental(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,294 | $1.4M |
| Prescription drug(15 contracts, 15 carriers) | KAISER FOUNDATION HEALTH PLANS OF SOUTHERN CALIFORNIA | 786 | $12.2M |
| Other | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 25 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,294 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.