| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | $27K | $1 | $27K | 1.96% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $37K | — | $37K | 7.37% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | — | $21K | 7.33% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 7.36% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $1K | $20K | 17.41% |
| PLANSOURNCE BENEFITS ADMIN INC3 Filed as: PLANSOURNCE BENEFITS ADMINISTRATION | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $193 | — | $193 | 0.17% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 7.30% |
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 | 1,126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 56 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 253 | $1.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,046 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,001 | $156K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $284K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $500K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,126 | $174K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,126 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,126 | — |
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.