| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 201503 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $217K | $14K | $230K | 10.62% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAIN LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $27K | — | $27K | 2.66% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 601478 CHARLOTTE, NC 28260 | EYEMED VISION CARE | $28K | — | $28K | 11.87% |
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 | 3,069 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $25K |
| Dental | KAISER FOUNDATION HEALTH PLAN INC | 209 | $1.0M |
| Vision | EYEMED VISION CARE | 4,172 | $235K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,069 | $2.2M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,069 | $2.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,069 | $2.2M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 209 | $1.0M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,069 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,172 | — |
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.