| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $256 | $256 | 0.01% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | SUTTER HEALTH PLAN | $57K | $0 | $57K | 5.00% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20K | $0 | $20K | 3.78% |
| ALLIANT INSURANCE SERVICES, INC.3 | 12657 ALCOSTA BOULEVARD, SUITE 175 SAN RAMON, CA 94583 | SUN LIFE ASSURANCE COMPANY OF CANADA | $98 | $0 | $98 | 0.02% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | $0 | $13K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DRIVE, CENTER II SUITE 305 ELMWOOD PARK, NJ 07407 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 1.02% |
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 | 856 | 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) | 856 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 489 | $4.3M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 856 | $535K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 856 | $535K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 856 | $535K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 489 | $4.3M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 856 | $535K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 856 | — |
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.