| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LLUMITY INC.3 | 71 3RD AVENUE SAN MATEO, CA 94401 | BLUE CROSS OF CALIFORNIA | $31K | $0 | $31K | 4.57% |
| LLUMITY INC.3 | 71 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 3.33% |
| NAMELY EMPLOYEE BENEFITS, LLC3 Filed as: NAMELY EMPLOYEE BENEFITS LLC | 195 BROADWAY, 15TH FLOOR NEW YORK, NY 10007 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.86% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SVCS., INC. | 3211 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.85% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING AGENCY | 71 HANOVER ROAD FLORHAM PARK, NJ 07932 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.84% |
| LLUMITY INC.3 | 71 3RD AVENUE SAN MATEO, CA 94401 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | $0 | $6K | 9.92% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 151 | $830K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 105 | $62K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 105 | $62K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 151 | $669K |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 151 | $669K |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 151 | $669K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 151 | $830K |
| Other | BLUE CROSS OF CALIFORNIA | 151 | $669K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.