| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 NORTH SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | BLUE CROSS OF CALIFORNIA | $151K | — | $151K | 2.57% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SVCS. WEST INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | BLUE CROSS OF CALIFORNIA | $31K | — | $31K | 0.52% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 NORTH SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 2.24% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.76% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 NORTH SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | $4K | $27K | 6.55% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 3000 TOWN CENTER, SUITE 2900 SOUTHFIELD, MI 48075 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 1.30% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ACCOCIATES INC. | 900 NORTH SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $18K | $25K | 15.27% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | 199 FREMONT STREET, 15TH FLOOR SAN FRANCISCO, CA 94105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.06% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ACCOCIATES INC. | 900 NORTH SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | ACE AMERICAN INSURANCE COMPANY | $2K | — | $2K | 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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,024 | $6.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 501 | $164K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 501 | $164K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 479 | $416K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 479 | $416K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 479 | $416K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,024 | $6.8M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 598 | $427K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,024 | — |
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.