| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | — | STANDARD INSURANCE COMPANY | $33K | — | $33K | 8.86% |
| VITA INSURANCE ASSOCIATES, INC.3 | — | DELTA DENTAL OF CALIFORNIA | $10K | — | $10K | 5.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | — | STANDARD INSURANCE COMPANY | $17K | — | $17K | 13.56% |
| VITA INSURANCE ASSOCIATES, INC.3 | — | STANDARD INSURANCE COMPANY | $8K | — | $8K | 8.87% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | VISION SERVICE PLAN | $2K | — | $2K | 4.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC. BROKER | Insurance agents and brokers Service code 22 | 900 NORTH SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | $95K |
| CIGNA HEALTH & LIFE INSURANCE COMP. EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $16K |
| CIGNA HEALTH & LIFE INS. COMPANY | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Named fiduciary; Other services; Direct payment from the plan Service code 12 | — | $0 |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 131 | $205K |
| Vision | VISION SERVICE PLAN | 129 | $35K |
| Life insurance | STANDARD INSURANCE COMPANY | 140 | $122K |
| Short-term disability | STANDARD INSURANCE COMPANY | 140 | $91K |
| Long-term disability | STANDARD INSURANCE COMPANY | 140 | $374K |
| Other | STANDARD INSURANCE COMPANY | 140 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.