| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 700 AIRPORT BOULEVARD SUITE 300 BURLINGAME, CA 94010 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 4.60% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 2270 DOUGLAS BOULEVARD SUITE 220 ROSEVILLE, CA 95661 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $18K | $1K | $19K | 10.71% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE I | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $1K | $6K | 12.97% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE I | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $8K | 17.89% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE I | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $550 | $3K | 12.44% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE I | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $243 | $2K | 17.57% |
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 | 127 | 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. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 49 | $305K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 135 | $181K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 135 | $181K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $43K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $45K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 95 | $473K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.