| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $42K | $0 | $42K | 1.80% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SVCS., LLC | PO BOX 750004 PETALUMA, CA 94975 | WESTERN HEALTH ADVANTAGE | $44K | $0 | $44K | 4.59% |
| ARROW BENEFITS GROUP3 Filed as: ARROW BENEFITS | PO BOX 750004 PETALUMA, CA 94975 | SUTTER HEALTH PLAN | $8K | $0 | $8K | 3.00% |
| EMERSON REID LLC3 | 350 5TH AVENUE, SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $12K | $17K | 17.33% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $1K | $0 | $1K | 2.75% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SVCS., LLC | PO BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $541 | $0 | $541 | 1.41% |
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 | 368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 327 | $3.6M |
| Vision | VISION SERVICE PLAN | 278 | $39K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $97K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $97K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 327 | $3.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.