| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN INC | $111K | $76 | $111K | 3.67% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 0.30% |
| BENEFITS MATCHMAKING LLC3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $1K | $13K | 6.18% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.48% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | PROFESSIONAL INSURANCE SERVIC 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 0.48% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $705 | $9K | 9.80% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | VISION SERVICE PLAN | $2K | — | $2K | 4.33% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 9.78% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA PBG | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 8.95% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 1451 GRANT ROAD, #200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $489 | — | $489 | 5.01% |
| BENEFITS MATCHMAKING LLC3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $492 | $340 | $832 | 9.70% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $429 | — | $429 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $63 | $144 | $207 | 2.41% |
| PROGESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $125 | $125 | 1.46% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $688 | — | $688 | 13.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA PBG | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $370 | — | $370 | 7.60% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $370 | — | $370 | 7.60% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $590 | — | $590 | 13.92% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $735 | $72 | $807 | 22.62% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
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 | 359 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 444 | $3.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 641 | $216K |
| Vision | VISION SERVICE PLAN | 322 | $35K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 361 | $108K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 361 | $93K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 361 | $93K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 444 | $3.0M |
| Other(7 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 361 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 641 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.