| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $120K | $5 | $120K | 5.48% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $40K | $2 | $40K | 5.02% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $29K | $0 | $29K | 7.94% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $3K | $9K | 15.00% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $6K | $0 | $6K | 10.00% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $2K | $8K | 20.00% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $894 | $447 | $1K | 15.00% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $430 | $2K | 20.00% |
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 | 700 | 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) | 705 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 482 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 456 | $367K |
| Vision | VISION SERVICE PLAN | 313 | $60K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 700 | $102K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 184 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 700 | — |
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.