| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $86K | — | $86K | 2.13% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | BLUE CROSS OF CALIFORNIA | $91K | — | $91K | 4.07% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | UNITED HEALTHCARE INSURANCE COMPANY | — | $43K | $43K | 4.39% |
| WELLS FARGO INSURANCE SERVICES3 | 333 SOUTH GRAND AVENUE, 20TH FLOOR LOS ANGELES, CA 90071 | HEALTH PLAN OF NEVADA | $19K | — | $19K | 3.42% |
| ROBERT C BRADLEY3 Filed as: ROBERT C. BRADLEY | 2399 HIGHWAY 34, BUILDING C2 MANASQUAN, NJ 08736 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $83K | — | $83K | 32.42% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33K | — | $33K | 12.84% |
| VOLUNTARY BENEFIT ADVISORS3 | 1936 EAST DEERE, SUITE 215 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 0.49% |
| WELLS FARGO INSURANCE SERVICES3 | 333 SOUTH GRAND AVENUE, 20TH FLOOR LOS ANGELES, CA 90071 | SIMNSA | $3K | — | $3K | 6.60% |
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 | 938 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 950 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,584 | $8.1M |
| Dental | SIMNSA | 32 | $44K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,584 | $3.2M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 1,584 | $2.2M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 1,584 | $2.2M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 1,584 | $2.2M |
| Prescription drug(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,584 | $7.9M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,584 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,584 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.