| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES, INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $18K | $0 | $18K | 0.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $7 | $0 | $7 | 0.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES, LLC. | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 2.00% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES, INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 10.10% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVS. USA, INC | 227 WEST TRADE STREET, SUITE 1500 A CHARLOTTE, NC 28202 | METLIFE LEGAL PLANS | $0 | $41 | $41 | 0.23% |
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 | 2,323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 929 | $5.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 734 | $168K |
| Vision | EYEMED | 2,143 | $159K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,323 | $767K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,323 | $767K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,323 | $767K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 929 | $5.4M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,323 | $822K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,323 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.