| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 2.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS, INC. 721 S. PARKER STREET, SUITE 300 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 2.55% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SERVICES | 777 MARINERS ISLAND BLVD. SUITE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 1.77% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SERVICES | 777 MARINERS ISLAND BLVD. SUITE 250 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS' SERVICE | $3K | — | $3K | 2.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $3K | — | $3K | 2.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 701 S. PARKER STREET, 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | $2K | — | $2K | 2.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 430 E. DOUGLAS AVENUE SUITE 400 WICHITA, KS 67202 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $739 | $7K | 6.75% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SERVICES | 777 MARINERS ISLAND BLVD. SUITE 250 SAN MATEO, CA 94404 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.48% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS INC. | 225 WIRELESS BLVD. HAUPPAUGE, NY 11788 | PRINCIPAL LIFE INSURANCE COMPANY | — | $3K | $3K | 2.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT | ADMINISTRATORS INC. 721 S. PARKER STREET, SUITE 300 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 1.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | CALIFORNIA PHYSICIANS' SERVICE | $1K | — | $1K | 2.82% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS, INC. 701 S. PARKER STREET, 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | $1K | — | $1K | 2.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SERVICES | 777 MARINERS ISLAND BLVD. SUITE 250 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS' SERVICE | $656 | — | $656 | 1.26% |
| IMA, INC.3 | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 2.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS INC. 721 S. PARKER STREET, SUITE 300 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 2.62% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SERVICES | 777 MARINERS ISLAND BLVD. SUITE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $842 | $50 | $892 | 1.80% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $491K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $109K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $109K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $109K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $109K |
| Prescription drug(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $491K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.