| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CALNONPROFITS INSURANCE SERVICES3 | P O BOX 640 CAPITOLA, CA 95010 | SUTTER HEALTH PLAN | $74K | — | $74K | 4.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | — | $30K | 4.47% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | VISION SERVICE PLAN | $2K | — | $2K | 4.66% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | LANDMARK HEALTHPLAN | $3K | — | $3K | 10.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.00% |
| NAC INSURANCE ADMINISTRATION CORPOR3 | P O BOX 640 CAPITOLA, CA 95010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 13.22% |
| SMITH, THOMAS, CHRISTOPHER3 | P O BOX 40386 NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.43% |
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 | 323 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 228 | $2.5M |
| Vision | VISION SERVICE PLAN | 189 | $34K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $33K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 10 | $6K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $13K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 228 | $2.5M |
| Other(3 contracts, 2 carriers) | LANDMARK HEALTHPLAN | 284 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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.