| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 S 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $47K | — | $47K | 2.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 S 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $33K | — | $33K | 2.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES NATIONAL INC | 213 S JEFFERSON ST SW ROANOKE, VA 24011 | HEALTHKEEPERS, INC. | $9K | — | $9K | 2.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 301 COLLEGE STREET 19TH FLOOR CHARLOTTE, NC 28202 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $4K | — | $4K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 220748 CHARLOTTE, NC 28222 | HARTFORD LIFE AND ACCIDENT | $19K | — | $19K | 11.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 301 COLLEGE STREET 19TH FLOOR CHARLOTTE, NC 28202 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC | $2K | — | $2K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERV NATIONAL INC | P.O. BOX 201503 DALLAS, TX 753201503 | HUMANA INSURANCE COMPANY | $932 | — | $932 | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 5200 N PALM AVE SUITE 114 FRESNO, CA 937042225 | AMERITAS LIFE INSURANCE CORPORATION | — | $320 | $320 | 1.44% |
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 | 416 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 423 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 572 | $4.5M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 418 | $22K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 480 | $165K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 480 | $165K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 480 | $165K |
| Other | HARTFORD LIFE AND ACCIDENT | 480 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 572 | — |
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."
No prospect flags tripped on this filing.