| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES, INC. | 130 THEORY STE 200 IRVINE, CA 92617 | KAISER FOUNDATION HEALTH PLAN INC | $87K | $8K | $94K | 2.91% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $23K | $0 | $23K | 0.72% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET SUITE 200 IRVINE, CA 92617 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $26K | $0 | $26K | 6.31% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $0 | $4K | 1.09% |
| FBP INSURANCE SERVICES3 | 130 THEORY STE 200 IRVINE, CA 92617 | VISION SERVICE PLAN | $4K | $0 | $4K | 6.56% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.89% |
| FBP INSURANCE SERVICES3 | 2000 CROW CANYON PL SUITE 220 SAN RAMON, CA 94583 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $2K | $5K | 10.31% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | $715 | $2K | 4.70% |
| FBP INSURANCE SERVICES3 | 2000 CROW CANYON PL SUITE 220 SAN RAMON, CA 94583 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $1K | $4K | 13.34% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $532 | $2K | 6.67% |
| FBP INSURANCE SERVICES3 | 2000 CROW CANYON PL SUITE 220 SAN RAMON, CA 94583 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $982 | $328 | $1K | 12.97% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $533 | $178 | $711 | 7.04% |
| FBP INSURANCE SERVICES3 | 2000 CROW CANYON PL SUITE 220 SAN RAMON, CA 94583 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $466 | $233 | $699 | 11.64% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $135 | $68 | $203 | 3.38% |
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 | 722 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 727 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 677 | $3.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 477 | $410K |
| Vision | VISION SERVICE PLAN | 318 | $57K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 722 | $46K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 677 | $3.2M |
| Other(3 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 722 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 722 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.