| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $26K | $10 | $26K | 4.83% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94043 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $13K | $36K | 9.59% |
| ENROLLEASE5 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$567 | — | -$567 | -0.15% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $194 | — | $194 | 4.72% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD #200 MOUNTAIN VIEW, CA 94043 | ZURICH AMERICAN INSURANCE COMPANY | $394 | — | $394 | 20.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC. EIN 94-2595918 BROKER | Insurance agents and brokers Service code 22 | — | $44K |
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 TPA | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | — | $36K |
| CIGNA LIFE AND HEALTH INS COMPANY | Contract Administrator; Claims processing; Non-monetary compensation; Participant communication; Other services; Named fiduciary; Direct payment from the plan; Float revenue 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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 109 | $534K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $375K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $375K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $375K |
| Short-term disability(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $379K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $375K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 109 | $534K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $377K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.