| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN, INC. | $20K | $0 | $20K | 3.01% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BOULEVARD MOUNTAIN VIEW, CA 94043 | CALIFORNIA PHYSICIANS' SERVICE | $14K | $0 | $14K | 3.86% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BOULEVARD MOUNTAIN VIEW, CA 94043 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $818 | $8K | 12.12% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD, SUITE 200 MOUNTAIN VIEW, CA 94040 | VISION SERVICE PLAN | $636 | $0 | $636 | 8.29% |
| LAURA RUNYEON3 | 981 QUARRY STREET PETALUMA, CA 94954 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $155 | $0 | $155 | 3.12% |
| ALAYNE MATA3 | 3276 KATY WAY LOOMIS, CA 95650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.83% |
| DARRYL W VIDOR3 Filed as: DARRYL W. VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.60% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.08% |
| WAYNE P. SMITH AND OTHER AGENTS3 Filed as: WAYNE P. SMITH & OTHER AGENTS | 402 WEST LOCKHART LANE MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.08% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMOIA, WA 98501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.06% |
| PROSESSION INC3 Filed as: PROSESSION, INC. | 950 UNIVERSITY PARK LOOP NORTH RENO, NV 89512 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.02% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $1.0M |
| Vision | VISION SERVICE PLAN | 49 | $8K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $63K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 7 | $5K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $63K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $1.0M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.