| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IVAR NORMAN JONES, JR3 | 1410 FRANKLIN ST STE 109 SAN FRANCISCO, CA 94109 | KAISER FOUNDATION HEALTH PLAN, INC. | $40K | — | $40K | 2.47% |
| JONES, IVAR N3 | 847 SANSOME ST FL 4 SAN FRANCISCO, CA 94111 | HUMANA INSURANCE COMPANY | $4K | $1K | $5K | 6.74% |
| BEERE & PURVES INC3 | 500 YGNACIO VALLEY ROAD SUITE 450 WALNUT CREEK, CA 94596 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 4.97% |
| IVAR N. JONES JR3 | 847 SANSOME ST FL 4 SAN FRANCISCO, CA 94111 | CALIFORNIACHOICE | $2K | — | $2K | 5.00% |
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 | 249 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 198 | $1.7M |
| Dental | HUMANA INSURANCE COMPANY | 184 | $82K |
| Vision | HUMANA INSURANCE COMPANY | 184 | $82K |
| Life insurance | HUMANA INSURANCE COMPANY | 184 | $82K |
| Other | HUMANA INSURANCE COMPANY | 184 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.