| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: HAYLOR FREYER & COON INC | 300 SOUTH STATE STREET, SUITE 1000 PO BOX 4743 SYRACUSE, NY 13221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | $883 | $18K | 7.50% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC | 3 PARKWAY NORTH BOULEVARD SUITE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 0.47% |
| INSURANCE CLERK3 Filed as: INSURANCE CLERK INSURANCE SERVICES | 1055 EAST COLORADO BOULEVARD 5TH FLOOR PASADENA, CA 91106 | KAISER FOUNDATION HEALTH PLAN, INC | $6K | $0 | $6K | 3.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 333 NORTH GLENOAKS BOULEVARD SUITE 410 BURBANK, CA 91502 | KAISER FOUNDATION HEALTH PLAN, INC | $3K | $0 | $3K | 1.44% |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC | 27 | $193K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $238K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $238K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $238K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $238K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $238K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $238K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.