| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | AETNA LIFE INSURANCE CO. | $52K | $603 | $52K | 4.14% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $25K | $0 | $25K | 4.54% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20K | $3K | $23K | 9.15% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 155 | $1.8M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 159 | $253K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 159 | $253K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 159 | $253K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 159 | $253K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 159 | $253K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 155 | $1.8M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 159 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.