| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST FL 6 SAN DIEGO, CA 921018156 | KAISER FOUNDATION HEALTH PLAN INC | $278K | $0 | $278K | 5.80% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE FL 12 WOODLAND HILLS, CA 913672584 | KAISER FOUNDATION HEALTH PLAN INC | $55K | $0 | $55K | 1.14% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE FL 12 WOODLAND HILLS, CA 913672584 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 0.12% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 911098299 | VISION SERVICE PLAN | $803 | $0 | $803 | 3.78% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE FL 12 WOODLAND HILLS, CA 913672584 | VISION SERVICE PLAN | $258 | $0 | $258 | 1.21% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $550 | $0 | $550 | 3.24% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE STE 1200 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $523 | $0 | $523 | 3.08% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $550 | $0 | $550 | 4.75% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE STE 1200 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $523 | $0 | $523 | 4.52% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $710 | $0 | $710 | 7.78% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE STE 1200 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $139 | $0 | $139 | 1.52% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST FL 6 SAN DIEGO, CA 921018156 | KAISER FOUNDATION HEALTH PLAN INC | $300 | $0 | $300 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KAISER FOUNDATION HEALTH PLAN, INC. EIN 94-1340523 ADMINISTRATOR | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | P.O. BOX 741562 LOS ANGELES, CA 900741562 | $5.2M |
| ANTHEM BLUE CROSS EIN 95-4331852 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | BOA LOCK BOX SERVICES LAC-005812 2706 MEDIA CENTER DRIVE LOS ANGELES, CA 90065 | $2.0M |
| CHOICE ADMINISTRATORS INC ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Contract Administrator Service code 12 | 721 S PARKER ST #200 ORANGE, CA 92868 | $353K |
| AMERICAN RIVER BENEFIT ADMIN EIN 68-0134480 ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | 3435 AMERICAN RIVER DRIVE SUITE B SACRAMENTO, CA 95864 | $158K |
| NORTH COAST BUILDERS EXCHANGE EIN 94-1262984 PARTY-IN-INTEREST | Other services; Direct payment from the plan Service code 49 | PO BOX 8070 SANTA ROSA, CA 954078070 | $150K |
| MARIN BUILDERS ASSOCIATION EIN 94-1415040 PARTY-IN-INTEREST | Direct payment from the plan; Other services Service code 49 | 660 LAS GALLINAS AVENUE SAN RAFAEL, CA 94903 | $116K |
| B.E.A.M.S, INC. EIN 68-0244529 PARTY-IN-INTEREST | Direct payment from the plan; Other services Service code 49 | PO BOX 8070 SANTA ROSA, CA 954078070 | $32K |
| BLUE CROSS OF CALIFORNIA EIN 95-3760890 CONTRACT ADMINISTRATOR | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | — | $27K |
| KEITH WOODS PROFESSIONAL SERVICES NONE | Consulting (general); Direct payment from the plan Service code 16 | 4774 CARISSA AVENUE SANTA ROSA, CA 95405 | $24K |
| CLIFTONLARSONALLEN, LLP EIN 41-0746749 PARTY-IN-INTEREST | Other services; Direct payment from the plan Service code 49 | PO BOX 31001-2433 PASADENA, CA 911102433 | $24K |
| BAY AREA BUILDERS EXCHANGE EIN 94-0348020 PARTY-IN-INTEREST | Direct payment from the plan; Other services Service code 49 | 3055 ALVARADO STREET SAN LEANDRO, CA 94577 | $22K |
| VISION SERVICE PLAN - CA EIN 94-1632821 ADMINISTRATOR | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | PO BOX 45210 SAN FRANCISCO, CA 941455210 | $21K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS EIN 95-4331852 CONTRACT ADMINISTRATOR | Float revenue; Insurance agents and brokers; Contract Administrator; Other commissions; Claims processing; Insurance brokerage commissions and fees; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | MAIL DROP OH3403A266 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $14K |
| MOSS ADAMS EIN 91-0189318 AUDITORS | Accounting (including auditing); Direct payment from the plan Service code 10 | 999 3RD AVENUE SEATTLE, WA 981044022 | $10K |
| SEGAL SELECT INSURANCE SERVICES, IN EIN 13-2619159 PARTY-IN-INTEREST | Insurance agents and brokers; Direct payment from the plan; Insurance services Service code 22 | PO BOX 21420 NEW YORK, NY 100871393 | $7K |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 659 | $4.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 328 | $30K |
| Life insurance(2 contracts) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 384 | $29K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 659 | $4.8M |
| Other(2 contracts) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 384 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 659 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.