| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $20K | $645 | $20K | 2.38% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.74% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $53 | $53 | 0.27% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHED | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | — | $2K | 12.06% |
| BONNI C CANARY4 | 285 SW FOREST COVE ROAD WEST LINN, OR 97068 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $172 | — | $172 | 7.50% |
| JONATHAN BOOTH4 | 3844 NE JOEL STREET MCMINNVILLE, OR 97128 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $35 | — | $35 | 1.53% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 137 | $850K |
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 137 | $850K |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 137 | $850K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 15 | $20K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 15 | $20K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 15 | $20K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 137 | $850K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 15 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.