| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD SAN FRANCISCO, CA 94131 | BLUE CROSS OF CALIFORNIA | $609K | $2K | $611K | 3.77% |
| ARCHON LLC3 Filed as: ARCHON, LLC | 1209 ORANGE STREET WILMINGTON, DE 19801 | BLUE CROSS OF CALIFORNIA | $0 | $5K | $5K | 0.03% |
| LUMITY, INC.3 | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN, INC. | $19K | $0 | $19K | 4.42% |
| LUMITY, INC.3 | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $51K | $0 | $51K | 13.00% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD SAN FRANCISCO, CA 94131 | VISION SERVICE PLAN | $14K | $0 | $14K | 9.65% |
| JIM FRENCH3 | 220 SOUTH KING STREET, SUITE 1200 HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $3K | $0 | $3K | 2.98% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $1K | $0 | $1K | 3.10% |
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 | 800 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 2,017 | $16.8M |
| Vision | VISION SERVICE PLAN | 778 | $150K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 800 | $389K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 800 | $389K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 800 | $389K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,017 | $16.7M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 800 | $389K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,017 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.