| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 Filed as: RELATION INS SVCS OF CALIFORNIA INC | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN, INC. | $22K | $0 | $22K | 6.60% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SVCS OF CALIFORNIA INC | 2300 CONTRA COSTA BOULEVARD PLEASANT HILL, CA 94523 | BLUE CROSS OF CALIFORNIA | $15K | $0 | $15K | 18.93% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 2677 NORTH MAIN STREET SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $0 | $7K | $7K | 9.47% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS SVCS LLC | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $0 | $1 | $1 | 0.00% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SVCS OF CALIFORNIA,INC | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | CALIFORNIA PHYSICIANS SERVICE | $2K | $0 | $2K | 5.16% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SVCS OF CALIFORNIA INC | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $503 | $0 | $503 | 5.00% |
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 | 179 | 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) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 42 | $411K |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 179 | $37K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 179 | $37K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 175 | $10K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 42 | $411K |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 175 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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.