| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | $39K | $172 | $40K | 4.67% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | $38 | $11K | 4.67% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | METROPOLITAN LIFE INSURANCE COMPANY | $536 | $386 | $922 | 0.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | SAFEGUARD HEALTH PLANS, INC. | $647 | $421 | $1K | 4.72% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE DRIVE MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC. | $323 | $323 | $646 | 2.85% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD., SUITE 100 AUSTIN, TX 78729 | SAFEGUARD HEALTH PLANS, INC. | — | $194 | $194 | 0.86% |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 193 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 192 | $1.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 172 | $132K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $110K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $110K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 192 | $1.1M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.