| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC. | $48K | $24 | $49K | 2.14% |
| PATRIOT GROWTH INSURANCE SERVICES3 | P.O. BOX 750004 PETALUMA, CA 94954 | WESTERN HEALTH ADVANTAGE | $25K | $0 | $25K | 2.69% |
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC. | P.O. BOX 750004 PETALUMA, CA 94954 | WESTERN HEALTH ADVANTAGE | $17K | $0 | $17K | 1.89% |
| ARROW BENEFITS GROUP3 Filed as: ARROW BENEFITS | P.O. BOX 750004 PETALUMA, CA 94975 | SUTTER HEALTH PLAN | $7K | $0 | $7K | 3.00% |
| EMERSON REID LLC3 | 261 MADISON AVE STE 602 NEW YORK, NY 10016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $11K | $16K | 16.85% |
| PATRIOT GROWTH INSURANCE SERVICES3 | P.O. BOX 750004 PETALUMA, CA 94954 | WESTERN HEALTH ADVANTAGE & NATIONAL HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 4.09% |
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC. | P.O. BOX 750004 PETALUMA, MO 94954 | WESTERN HEALTH ADVANTAGE & NATIONAL HEALTH INSURANCE COMPANY | $534 | $0 | $534 | 0.92% |
| SSM INSURANCE SERVICES, INC.3 | P.O. BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.04% |
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 | 296 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 294 | $3.5M |
| Vision | VISION SERVICE PLAN | 245 | $37K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $92K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $92K |
| Prescription drug | SUTTER HEALTH PLAN | 34 | $223K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 293 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.