| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 4TH FLOOR SAN DIEGO, CA 92101 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 9.03% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING CORP. | 323 WEST 39TH STREET, 11TH FLOOR NEW YORK, NY 10018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.57% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $742 | $742 | 0.62% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 NORTH CALIFORNIA BOULEVARD SUITE 1000 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 4.17% |
| MBL BENEFITS CONSULTING CORP3 Filed as: MBL BENEFITS CONSULTING CORP. | 323 WEST 39TH STREET, 11TH FLOOR NEW YORK, NY 10018 | KAISER FOUNDATION HEALTH PLAN INC | $579 | $0 | $579 | 0.59% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $125 | $125 | 0.13% |
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 | 185 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 185 | $98K |
| Dental | DELTA DENTAL OF CALIFORNIA | 351 | $169K |
| Vision | VISION SERVICE PLAN | 185 | $0 |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $120K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $120K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $120K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 185 | $98K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 351 | — |
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.