| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | BLUE CROSS OF CALIFORNIA | $67K | — | $67K | 1.88% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SERVICES WEST | 29840 NETWORK PLACE CHICAGO, IL 60673 | BLUE CROSS OF CALIFORNIA | $28K | — | $28K | 0.77% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 2 N. MARKET STREET, SUITE 420 SAN JOSE, CA 951131211 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | — | $31K | 1.86% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | P.O. BOX 905494 CHARLOTTE, NC 282905494 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | — | $19K | 1.14% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | DELTA DENTAL OF CALIFORNIA | $15K | — | $15K | 2.78% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE | 29840 NETWORK PLACE CHICAGO, IL 60673 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 2.22% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 6.48% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 3.52% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 951132339 | VISION SERVICE PLAN | $2K | — | $2K | 1.66% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29540 NETWORK PLACE CHICAGO, IL 606731298 | VISION SERVICE PLAN | $1K | — | $1K | 1.34% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 7.15% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29540 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.85% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 7.14% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NATWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $850 | — | $850 | 2.86% |
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 | 726 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 206 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 932 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,039 | $5.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,747 | $527K |
| Vision | VISION SERVICE PLAN | 621 | $101K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 726 | $160K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 729 | $75K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,039 | $5.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 726 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,747 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.