| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 0.75% |
| PATRA CORPORATION3 | 1107 INVESTMENT BOULEVARD SUITE 100 EL DORADO HILLS, CA 95762 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $473 | $0 | $473 | 2.60% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $524 | $524 | 3.19% |
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 | 490 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 515 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 625 | $5.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 929 | $410K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 855 | $52K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 538 | $407K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 538 | $407K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 538 | $423K |
| Prescription drug(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 625 | $5.7M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 538 | $407K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 929 | — |
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.