| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CALNONPROFITS INSURANCE SERVICES3 | 1500 41ST AVENUE, SUITE 280 CAPITOLA, CA 95010 | KAISER FOUNDATION HEALTH PLAN INC | $60K | — | $60K | 2.31% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | 1500 41ST AVENUE, SUITE 280 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $867 | $7K | 17.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | 1500 41ST AVENUE, SUITE 280 CAPITOLA, CA 95010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $903 | — | $903 | 4.04% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | 1500 41ST AVENUE, SUITE 280 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $503 | — | $503 | 2.91% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | 1500 41ST AVENUE, SUITE 280 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $961 | $192 | $1K | 12.00% |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 386 | $2.6M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 200 | $53K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 53 | $40K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 386 | $2.6M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 200 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.