| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $134K | $2K | $137K | 12.67% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94043 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 4.50% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRAND ROAD #200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | $1 | $9K | 4.90% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | $6K | $24K | 13.63% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | VISION SERVICE PLAN | $2K | — | $2K | 3.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 TPA | Float revenue; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Claims processing; Named fiduciary; Contract Administrator Service code 12 | — | $62K |
| MAVEN CLINIC CO. EIN 46-5747423 TPA | Direct payment from the plan; Other services Service code 49 | — | $24K |
| CIGNA LIFE AND HEALTH INSURANCE CO. | Non-monetary compensation; Contract Administrator; Float revenue; Claims processing; Named fiduciary; Direct payment from the plan; Participant communication; Other services Service code 12 | — | $0 |
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 | 172 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $1.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 166 | $259K |
| Vision | VISION SERVICE PLAN | 171 | $57K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 258 | $174K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 258 | $174K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 258 | $174K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $1.3M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 258 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.