| 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 | $224K | $88K | $312K | 15.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAIN LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $35K | — | $35K | 3.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201503 DALLAS, TX 75320 | EYEMED VISION CARE | $13K | — | $13K | 6.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, SUITE 200 SAINT LOUIS, MN 55426 | EYEMED VISION CARE | $7K | — | $7K | 3.54% |
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 | 2,333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 2,333 | $1.0M |
| Vision | EYEMED VISION CARE | 5,483 | $198K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,433 | $2.0M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,433 | $2.0M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,433 | $2.0M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 183 | $1.0M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,433 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,483 | — |
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.