| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE, INC. | 401 UNION STREET 31ST FLOOR SEATTLE, WA 98101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | $74K | $85K | 2.74% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 899 CASSATT ROAD SUITE 200 BERWYN, PA 19312 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $14K | $16K | 0.52% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 1420 5TH AVENUE SUITE 1500 SEATTLE, WA 98101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $18K | $3K | $21K | 17.23% |
| AMERICAN BENEFITS AND COMPENSATION3 Filed as: AMERICAN BENEFITS & COMPENSATION SY | 101 PARK AVENUE 14TH FLOOR NEW YORK, NY 10178 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 5.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, INC, | 1420 5TH AVENUE SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 6.04% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 2.41% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GEN AGENCY | 899 CASSATT ROAD SUITE 200 BERWYN, PA 19312 | KAISER FOUNDATION HEALTH PLAN, INC. | $736 | — | $736 | 1.24% |
| PRAW INSURANCE SERVICES3 Filed as: PRAW INSURANCES SERVICES | 14011 VENTURA BLVD SUITE 215 SHERMAN OAKS, CA 91423 | KAISER FOUNDATION HEALTH PLAN, INC. | $942 | — | $942 | 6.42% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICE GA | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN, INC. | $325 | — | $325 | 2.21% |
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 | 297 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 229 | $3.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 229 | $3.1M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 229 | $3.1M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 426 | $120K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 426 | $120K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 426 | $120K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 426 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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.