| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 4.61% |
| LEAVITT GROUP3 Filed as: LEAVITT PACIFIC INSURANCE BROKERS | 1570 THE ALAMEDA SUITE 101 SAN JOSE, CA 951262335 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.43% |
| FILICE INSURANCE AGENCY3 Filed as: FELICE INSURANCE SERVICES LLC | 738 N 1ST STREET SUITE 202 SAN JOSE, CA 951126371 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $864 | $864 | 0.16% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $476 | $5K | 4.64% |
| CLAREMONT BUSINESS GROUP3 Filed as: CLAREMONT BUSINESS GROUP INC. | 1000 BURNETT AVE SUITE 440 CONCORD, CA 945202088 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.24% |
| LEAVITT GROUP3 Filed as: LEAVITT PACIFIC INSURANCE BROKERS | 1570 THE ALAMEDA SUITE 101 SAN JOSE, CA 951262335 | PRINCIPAL LIFE INSURANCE COMPANY | $676 | — | $676 | 0.59% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 132 | $543K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $115K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 172 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.