| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 10265 BIRMINGHAM, AL 35202 | BLUE CROSS OF CALIFORNIA | $185K | $32K | $216K | 1.76% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $153K | $0 | $153K | 1.25% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B STREET, SUITE 2400 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $55K | $0 | $55K | 1.06% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $31K | $0 | $31K | 0.59% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | HARTFORD LIFE AND ACCIDENT | $3K | $292 | $3K | 16.50% |
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 | 1,651 | 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) | 1,662 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,039 | $17.5M |
| Vision | VISION SERVICE PLAN | 1,359 | $172K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,651 | $762K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,651 | $762K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,039 | $17.5M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,651 | $812K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,039 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.