| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PE INSURANCE SERVICES LLC3 | 1676 N CALIFORNIA BLVD SUITE 400 WALNUT CREEK, CA 94596 | GUARDIAN | $20K | — | $20K | 2.42% |
| MARIBEL ORTIZ3 | 750 BATTERY STREET 7TH FLOOR SAN FRANCISCO, CA 94111 | MOTIVHEALTH | $5K | — | $5K | 1.05% |
| AMY MENSEN3 | 750 BATTERY STREET 7TH FLOOR SAN FRANCISCO, CA 94111 | MOTIVHEALTH | $3K | — | $3K | 0.74% |
| PE INSURANCE SERVICES LLC3 Filed as: PE INSURANCE SERVICES, LLC | 750 BATTERY STREET FLOOR 6 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN | $9K | $2K | $11K | 5.39% |
| PE INSURANCE SERVICES LLC3 Filed as: PE INSURANCE SERVICES | 750 BATTERY STREET 7TH FLOOR SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | — | $14K | 7.31% |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN | 37 | $384K |
| Dental | GUARDIAN | 0 | $828K |
| Life insurance | GUARDIAN | 0 | $828K |
| Short-term disability | GUARDIAN | 0 | $828K |
| Long-term disability | GUARDIAN | 0 | $828K |
| Prescription drug | MOTIVHEALTH | 185 | $471K |
| Stop-loss / reinsurancereinsurance | MOTIVHEALTH | 185 | $471K |
| Other | GUARDIAN | 0 | $828K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.