| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $22K | $872 | $23K | 2.60% |
| AMWINS3 Filed as: LISI, INC. | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC | $17K | $0 | $17K | 1.97% |
| DE LA TORRE AND ASSOCIATES3 | 1900 ALAMEDA DE LAS PULGAS SUITE 108 SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN INC | $17K | $0 | $17K | 1.94% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 6.00% |
| DE LA TORRE AND ASSOCIATES3 | 2929 CAMPUS DRIVE, SUITE 410 SAN MATEO, CA 94403 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.83% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICES INC. | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $1K | $4K | 2.86% |
| ALLIANT INSURANCE SERVICES, INC. | 2121 NORTH CALIFORNIA BOULEVARD SUITE 1000 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $0 | $1K | 3.62% |
| ALLIANT INSURANCE SERVICES, INC. | 100 PINE STREET SAN FRANCISCO, CA 94111 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.83% |
| DE LA TORRE AND ASSOCIATES3 | 2929 CAMPUS DRIVE SAN MATEO, CA 94403 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $734 | $0 | $734 | 4.38% |
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 | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 173 | $908K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 196 | $136K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 140 | $17K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 196 | $136K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 196 | $136K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 173 | $908K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 196 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.