| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | $0 | $18K | 3.04% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2270 DOUGLAS BOULEVARD, SUITE 220 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $0 | $12K | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | KAISER FOUNDATION HEALTH PLAN, INC. | -$269 | $0 | -$269 | -0.05% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 5401 OLD REDWOOD HIGHWAY, SUITE 105 PETALUMA, CA 94954 | SUTTER HEALTH PLAN | $11K | $0 | $11K | 5.00% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SVCS/PEO DIV. | UNKNOWN SANTA ROSA, CA 95403 | DELTA DENTAL FFS | $3K | $0 | $3K | 7.54% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | UNKNOWN SANTA ROSA, CA 95403 | DELTA DENTAL FFS | $2K | $0 | $2K | 3.32% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 140 2ND STREET, SUITE 318 PETALUMA, CA 94952 | DELTA DENTAL FFS | $758 | $0 | $758 | 1.64% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SVCS/PEO DIV. | UNKNOWN SANTA ROSA, CA 95403 | DELTACARE USA | $1K | $0 | $1K | 7.56% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | UNKNOWN SANTA ROSA, CA 95403 | DELTACARE USA | $507 | $0 | $507 | 3.30% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 140 2ND STREET, SUITE 318 PETALUMA, CA 94952 | DELTACARE USA | $250 | $0 | $250 | 1.63% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SVCS/PEO DIV. | UNKNOWN SANTA ROSA, CA 95403 | VISION SERVICE PLAN | $914 | $0 | $914 | 7.54% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | UNKNOWN SANTA ROSA, CA 95403 | VISION SERVICE PLAN | $400 | $0 | $400 | 3.30% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 140 2ND STREET, SUITE 318 PETALUMA, CA 94952 | VISION SERVICE PLAN | $199 | $0 | $199 | 1.64% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 121 | $800K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL FFS | 97 | $61K |
| Vision | VISION SERVICE PLAN | 97 | $12K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 121 | $800K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.