| 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 | $50K | $1K | $51K | 9.72% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 3.83% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $1 | $4K | 3.85% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | STE 200 1451 GRANT RD MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 12.24% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | STE 250 280 E. 96TH STREET INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $3K | — | $3K | 5.38% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | STE 200 1451 GRANT RD MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $195 | $1K | 14.28% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $54 | $1K | 32.16% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | STE 200 1451 GRANT RD MOUNTAIN VIEW, CA 94040 | FIRST UNUM LIFE INSURANCE COMPANY | $265 | $36 | $301 | 9.21% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | STE 250 280 E. 96TH STREET INDIANAPOLIS, IN 46240 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT RD STE 200 MOUNTAIN VIEW, CA 94040 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $48 | $10 | $58 | 12.31% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E. 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | — | $0 | 0.00% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | 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 | 98 | $686K |
| Dental | DELTA DENTAL OF CALIFORNIA | 113 | $129K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 112 | $4K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 112 | $85K |
| Short-term disability(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 112 | $89K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 112 | $85K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 98 | $686K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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.