| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN 10TH FLOOR IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $357K | — | $357K | 5.28% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN 10TH FLOOR IRVINE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $13K | $145 | $13K | 37.12% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN 10TH FLOOR IRVINE, CA 92612 | VISION SERVICE PLAN | $891 | — | $891 | 4.99% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN 10TH FLOOR IRVINE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $999 | — | $999 | 11.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN RIVER BENEFIT ADMIN. EIN 68-0134480 PARTY-IN-INTEREST | Direct payment from the plan; Contract Administrator Service code 13 | — | $178K |
| B.E.A.M.S., INC. EIN 68-0244529 PARTY-IN-INTEREST | Other services; Direct payment from the plan Service code 49 | — | $126K |
| MARIN BUILDERS ASSOCATION EIN 94-1415040 PARTY-IN-INTEREST | Other services; Direct payment from the plan Service code 49 | — | $121K |
| MOSS ADAMS EIN 91-0189318 AUDITORS | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $63K |
| NORTH COAST BUILDERS EXCHANGE EIN 94-1262984 PARTY-IN-INTEREST | Direct payment from the plan; Other services Service code 49 | — | $52K |
| ANTHEM BLUE CROSS EIN 95-4331852 CONTRACT ADMINISTRATOR | Other services; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $44K |
| KEITH WOODS PROFESSIONAL SERVICES NONE | Direct payment from the plan; Consulting (general) Service code 16 | 4774 CARISSA AVENUE SANTA ROSA, CA 95105 | $11K |
| BAY AREA BUILDERS EXCHANGE EIN 94-0348020 PARTY-IN-INTEREST | Other services; Direct payment from the plan Service code 49 | — | $9K |
| SEGAL SELECT INSURANCE SERVICES EIN 13-2619159 PARTY-IN-INTEREST | Insurance services; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $6K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 CONTRACT ADMINSTRATOR | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $0 |
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 | 800 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 805 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 730 | $6.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 199 | $27K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 201 | $36K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 730 | $6.8M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 201 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 730 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.