| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASCENSION INSURANCE AGENCY3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $35K | $0 | $35K | 5.17% |
| ASCENSION INSURANCE AGENCY3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 10.00% |
| PORTAL INSURANCE AGENCY, INC.3 Filed as: PORTAL INSURANCE AGENCY INC | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 13.98% |
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION BENEFITS & SOLUTIONS | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | EYEMED | $317 | $0 | $317 | 4.80% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SVCS OF CA. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | EYEMED | $132 | $0 | $132 | 2.00% |
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 | 112 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 102 | $684K |
| Dental | DELTA DENTAL OF CALIFORNIA | 200 | $84K |
| Vision | EYEMED | 106 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $36K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 102 | $684K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.