| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE., #200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN OF CALIFORNIA | $33K | $0 | $33K | 2.40% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE., #200 SANTA CRUZ, CA 95062 | HEALTH NET | $20K | $0 | $20K | 2.89% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE., #200 SANTA CRUZ, CA 95062 | UNION SECURITY INSURANCE COMPANY | $6K | $0 | $6K | 3.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE., #200 SANTA CRUZ, CA 95062 | THE HARTFORD | $4K | $0 | $4K | 10.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE., #200 SANTA CRUZ, CA 95062 | BLUE CROSS OF CALIFORNIA | $978 | $0 | $978 | 10.20% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE., #200 SANTA CRUZ, CA 95062 | UDC DENTAL OF CALIFORNIA, INC. | $670 | $0 | $670 | 9.99% |
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 | 605 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 605 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF CALIFORNIA | 203 | $2.1M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 175 | $198K |
| Life insurance(2 contracts, 2 carriers) | THE HARTFORD | 213 | $53K |
| Short-term disability | THE HARTFORD | 37 | $44K |
| Long-term disability | THE HARTFORD | 37 | $44K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF CALIFORNIA | 203 | $2.1M |
| Other(3 contracts, 3 carriers) | THE HARTFORD | 605 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 605 | — |
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.