| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOTERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | KAISER FOUNDATION HEALTH PLAN INC | $113K | $43 | $113K | 3.66% |
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC | PO BOX 750004 PETALUMA, CA 949750004 | KAISER FOUNDATION HEALTH PLAN INC | $77 | $0 | $77 | 0.00% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | KAISER FOUNDATION HEALTH PLAN INC | $32K | $0 | $32K | 4.02% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | WESTERN HEALTH ADVANTAGE | $22K | $0 | $22K | 4.60% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | SUTTER HEALTH PLAN | $14K | $0 | $14K | 4.99% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | VISION SERVICE PLAN | $9K | $0 | $9K | 10.17% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 15.00% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 10.00% |
| EMPLOYERS SELECT INSURANCE SERVICES3 | 5701 LONETREE BLVD STE 305 ROCKLIN, CA 95765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.00% |
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 | 901 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 901 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 596 | $4.6M |
| Vision | VISION SERVICE PLAN | 447 | $88K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 901 | $99K |
| Prescription drug | SUTTER HEALTH PLAN | 65 | $271K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 901 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.