| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | STANDARD INSURANCE COMPANY | $65K | $17K | $82K | 7.46% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC. | $10K | $0 | $10K | 2.46% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $37K | $23K | $60K | 19.00% |
| DOUGLAS GEORGE KEELER3 Filed as: DOUGLAS KEELER | DODGE COURT PLATTSMOUTH, NE 68048 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 3.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CLARENCE GALLAGHER | 8605 EMERSON ROAD PLATTSMOUTH, NE 68048 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.34% |
| SHAWN J KEELER3 Filed as: SHAWN KEELER | 7428 SOUTH 95TH STREET LA VISTA, NE 68128 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.34% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | 320 WEST 57TH STREET NEW YORK, NY 10019 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $425 | $425 | 0.13% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $484 | $0 | $484 | 2.35% |
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 | 1,580 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,596 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC. | 78 | $416K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 979 | $317K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 979 | $317K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,580 | $1.1M |
| Short-term disability | STANDARD INSURANCE COMPANY | 1,580 | $1.1M |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,580 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS INC. | 78 | $416K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,580 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,580 | — |
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.