| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BOULEVARD MOUNTAIN VIEW, CA 94043 | AETNA | $45K | $0 | $45K | 2.71% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: WORD & BROWN INSURANCE ADMIN, INC. | UNKNOWN LONG BEACH, CA 90806 | AETNA | $14K | $0 | $14K | 0.85% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | $0 | $17K | 4.91% |
| THE BALDWIN GROUP WEST LLC3 Filed as: BALDWIN GROUP WEST, LLC | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $134 | $134 | 0.04% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $0 | $8K | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 315 MONTGOMERY STREET, SUITE 900 SAN FRANCISCO, CA 94104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 4.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, SUITE 100 AUSTIN, TX 78766 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $4K | $4K | 4.99% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BOULEVARD MOUNTAIN VIEW, CA 94043 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.16% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $459 | $3K | 4.69% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.35% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$94 | $0 | -$94 | -0.16% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | METROPOLITAN LIFE INSURANCE COMPANY | $621 | $0 | $621 | 9.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 315 MONTGOMERY STREET, SUITE 900 SAN FRANCISCO, CA 94104 | METROPOLITAN LIFE INSURANCE COMPANY | $311 | $0 | $311 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, SUITE 100 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $186 | $186 | 2.99% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA | 108 | $2.0M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 89 | $87K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 89 | $81K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $60K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $60K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $60K |
| Prescription drug(2 contracts, 2 carriers) | AETNA | 108 | $2.0M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.