| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC. | $127K | $4 | $127K | 4.50% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5003 SAN RAMON, CA 94583 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | $4K | $27K | 11.71% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $14K | — | $14K | 10.82% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 4.97% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.10% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 2.27% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AMERICAN FIDELITY ASSURANCE COMPANY | $658 | — | $658 | 0.77% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 6.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.93% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5003 SAN RAMON, CA 91189 | SAFEGUARD HEALTH PLANS, INC. | $4K | $727 | $5K | 11.38% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.99% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 3.36% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $953 | — | $953 | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $564 | — | $564 | 2.96% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $482 | — | $482 | 4.92% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$3K | — | -$3K | -33.39% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $253 | — | $253 | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $167 | — | $167 | 3.30% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $567 | — | $567 | 13.76% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $206 | — | $206 | 5.00% |
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 | 518 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 522 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 547 | $3.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 864 | $278K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 864 | $235K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 864 | $235K |
| Short-term disability(8 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 218 | $358K |
| Long-term disability(8 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 218 | $358K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 547 | $2.8M |
| Other(9 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 864 | $593K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 864 | — |
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.