| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 N MAIN ST STE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $39K | — | $39K | 2.80% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | $12 | $28K | 2.03% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 N MAIN ST STE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 5.88% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.11% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 N MAIN ST STE 700 WALNUT CREEK, CA 94596 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 10.40% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 4.95% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 N MAIN ST STE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.90% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $963 | — | $963 | 4.97% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | VISION SERVICE PLAN | $608 | — | $608 | 4.16% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 N MAIN ST STE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $862 | — | $862 | 7.43% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $475 | — | $475 | 4.10% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 200 | $1.4M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $84K |
| Vision | VISION SERVICE PLAN | 125 | $15K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $12K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $19K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 200 | $1.4M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 127 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.