| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DR SUITE 100 MENLO PARK, CA 94025 | KAISER HEALTH FOUNDATION PLAN INC | $8K | — | $8K | 2.87% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER HEALTH FOUNDATION PLAN INC | $6K | — | $6K | 2.11% |
| INTERNATIONAL PROINSURANCE SERVICES3 | PO BOX 2540 MENLO PARK, CA 94026 | DELTA DENTAL | $7K | — | $7K | 6.61% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | DELTA DENTAL | $4K | — | $4K | 3.39% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DR SUITE100 MENLO PARK, CA 94025 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $1K | $5K | 8.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 4.22% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE SUITE 100 MENLO PARK, CA 94025 | EYEMED | $2K | — | $2K | 11.54% |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER HEALTH FOUNDATION PLAN INC | 47 | $272K |
| Dental | DELTA DENTAL | 178 | $113K |
| Vision | EYEMED | 174 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $53K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $53K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $53K |
| Prescription drug | KAISER HEALTH FOUNDATION PLAN INC | 47 | $272K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 150 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.