| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | $0 | $11K | 3.04% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | $0 | $6K | 1.68% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA | $26K | — | $26K | 10.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN., INC. | UNKNOWN LONG BEACH, CA 90806 | AETNA | $11K | — | $11K | 4.48% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | AETNA | $10K | — | $10K | 4.36% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE MATRIX | $5K | $0 | $5K | 6.44% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 AUSTIN, TX 78766 | RELIANCE MATRIX | $0 | $4K | $4K | 4.99% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | RELIANCE MATRIX | $3K | $0 | $3K | 3.57% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE, SUITE 200 SAINT PETERSBURG, FL 33702 | RELIANCE MATRIX | $3K | $0 | $3K | 3.21% |
| GIS BENEFITS INC3 Filed as: GIS NORTHERN CALIFORNIA | 315 MONTGOMERY STREET, SUITE 900 SAN FRANCISCO, CA 94104 | RELIANCE MATRIX | $2K | $0 | $2K | 1.78% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.94% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 AUSTIN, TX 78766 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.47% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.59% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE, SUITE 200 SAINT PETERSBURG, FL 33702 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.21% |
| GIS BENEFITS INC3 Filed as: GIS NORTHERN CALIFORNIA | 315 MONTGOMERY STREET, SUITE 900 SAN FRANCISCO, CA 94104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $839 | $0 | $839 | 1.79% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 116 | $609K |
| Dental(2 contracts, 2 carriers) | RELIANCE MATRIX | 138 | $84K |
| Vision | RELIANCE MATRIX | 138 | $84K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $47K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $47K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $47K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 116 | $609K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 123 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.