| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VANTREO INSURANCE BROKERAGE3 Filed as: VANTREO INSURANCE BROKERS | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | — | $30K | 2.86% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 1.89% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | AMERITAS LIFE INSURANCE CORP. | $692 | $160 | $852 | 6.63% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | AMERITAS LIFE INSURANCE CORP. | $593 | — | $593 | 4.61% |
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 | 118 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 233 | $1.0M |
| Vision | AMERITAS LIFE INSURANCE CORP. | 119 | $13K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 233 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.