| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $26K | $1 | $26K | 4.01% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 10.00% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 14.03% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $683 | $0 | $683 | 10.01% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 78 | $658K |
| Dental | DELTA DENTAL OF CALIFORNIA | 156 | $83K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 129 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $20K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 78 | $658K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.