| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $44K | — | $44K | 13.88% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | $3 | $11K | 4.81% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $10K | — | $10K | 4.64% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 4.75% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $5K | $16K | 17.43% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $190 | — | $190 | 6.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $4K |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $774K |
| Dental | DELTA DENTAL OF CALIFORNIA | 129 | $113K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $89K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $89K |
| Short-term disability(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $92K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 137 | $89K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $774K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.