| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HENDERSON STRATEGIC FIN INS SVCS3 Filed as: HENDERSON STRATEGIC FINANCIAL INSUR | 855 EL CAMINO REAL STE 220 PALO ALTO, CA 94301 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 4.85% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 0.97% |
| HENDERSON STRATEGIC FIN INS SVCS3 | 855 EL CAMINO REAL BUILDING 4, SUITE 220 PALO ALTO, CA 94301 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $49K | $932 | $50K | 12.85% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $18K | $18K | 4.59% |
| HENDERSON STRATEGIC FIN INS SVCS3 Filed as: HENDERSON STRATEGIC FINAN | 855 EL CAMINO REAL BUILDING 4 STE 220 PALO ALTO, CA 94301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| BENEFITMALL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 5.00% |
| HENDERSON STRATEGIC FIN INS SVCS3 Filed as: HENDERSON STRATEGIC FINAN | 855 EL CAMINO REAL BUILDING 4 STE 220 PALO ALTO, CA 94301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| BENEFITMALL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $591 | $591 | 5.69% |
| HENDERSON STRATEGIC FIN INS SVCS3 Filed as: HENDERSON STRATEGIC FINAN | 855 EL CAMINO REAL BUILDING 4 STE 220 PALO ALTO, CA 94301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| BENEFITMALL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $12 | $12 | 0.12% |
| HENDERSON STRATEGIC FIN INS SVCS3 Filed as: HENDERSON STRATEGIC FINAN | 855 EL CAMINO REAL BUILDING 4 STE 220 PALO ALTO, CA 94301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $285 | — | $285 | 10.01% |
| BENEFITMALL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $142 | $142 | 4.99% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 96 | $545K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 129 | $391K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 129 | $391K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $23K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.