| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | — | $19K | 5.01% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNION SECURITY INSURANCE COMPANY | $2.0M | — | $2.0M | 999.82% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 4.92% |
| COLONIAL LIFE & ACCIDENT3 | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL - SEE ATTACHMENT | $28K | $8K | $35K | 48.34% |
| BRIARE B. MICHAEL3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | — | $4K | 4.99% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, #200 ROSEVILLE, CA 95678 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $1K | $7K | 18.32% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 9.90% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, # 200 ROSEVILLE, CA 95676 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $583 | $3K | 12.59% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | UDC DENTAL OF CALIFORNIA, INC. | $1K | — | $1K | 9.99% |
| TEVIS INSURANCE SOLUTIONS3 Filed as: TEVIS INSURANCE SOLUTIONS LLC | 970 RESERVE DRIVE, #200 ROSEVILLE, CA 95678 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $666 | — | $666 | 15.00% |
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 | 638 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 649 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 71 | $628K |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 278 | $210K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 299 | $32K |
| Life insurance(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 638 | $63K |
| Short-term disability | COLONIAL - SEE ATTACHMENT | 100 | $73K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 71 | $628K |
| Other(3 contracts, 2 carriers) | COLONIAL - SEE ATTACHMENT | 638 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 638 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.