| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 5.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 1.27% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 5.01% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 4.86% |
| MICHAEL B BRIARE3 | 970 RESERVE DRIVE SUITE 200 ROSEVILLE, CA 95678 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 10.00% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $3K | $12K | 29.18% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 90 | $893K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 166 | $123K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 166 | $123K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 166 | $164K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 68 | $41K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 166 | $123K |
| Prescription drug(3 contracts, 2 carriers) | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 90 | $852K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 166 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.