| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIPPLING INSURANCE SERVICES INC3 | — | CIGNA | $3K | — | $3K | 0.84% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS INC | — | GUARDIAN | $8K | — | $8K | 5.00% |
| RIPPLING INSURANCE SERVICES INC3 | — | GUARDIAN | $7K | $349 | $7K | 4.50% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS, INC | 8777 N GAINEY CENTER DR. SUITE 260 SCOTTSDALE, AZ 85258 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.25% |
| RIPPLING INSURANCE SERVICES INC3 Filed as: RIPPLING INSURANCE SERVICES, INC. | 2443 FILLMORE STREET #380-7361 SAN FRANCISCO, CA 94115 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RIPPLING INSURANCE SERVICES EIN 82-2575867 BROKER | Insurance agents and brokers Service code 22 | — | $40K |
| NFP CA INSURANCE SERVICES INC EIN 94-2741175 BROKER | Insurance agents and brokers Service code 22 | — | $26K |
| CIGNA EIN 59-1031071 TPA | Contract Administrator Service code 13 | — | $21K |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 160 | $413K |
| Dental(2 contracts, 2 carriers) | GUARDIAN | 136 | $205K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 136 | $205K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 136 | $205K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 136 | $205K |
| 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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.