| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | KAISER FOUNDATION HEALTH PLAN | $18K | $4 | $18K | 3.51% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | BLUE SHIELD OF CALIFORNIA; CALIFORNIA PHYSICIANS' SERVICE | $12K | — | $12K | 4.37% |
| VITA INSURANCE ASSOCIATES, INC.3 | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $566 | $7K | 12.59% |
| ENROLLEASE5 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.91% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | VISION SERVICE PLAN | $641 | — | $641 | 8.14% |
| LAURA RUNYEON3 | 2042 WEATHERBY WAY PETALUMA, CA 94954 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $257 | $39 | $296 | 5.69% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 1451 GRANT RD MOUNTAIN VIEW, CA 94040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 1.50% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | — | $57 | 1.10% |
| DARRYL W VIDOR3 | 3314 EUROPA ST ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.61% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $6 | $25 | 0.48% |
| PROSESSION INC3 Filed as: PROSESSION INC. | 950 UNIVERSITY PARK LOOP N RENO, NV 89512 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.08% |
| WAYNE RIMMER3 Filed as: WAYNE P SMITH | 402 WEST LOCKHART LANE MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.06% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.04% |
| JAN HEJRET3 | 644 N 17TH ST SAN JOSE, CA 95112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.04% |
| MANDEEP TEJA3 | 1548 SAINT FRANCIS DR SAN JOSE, CA 95125 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.04% |
| MARY KOCH3 | 117 WOLF RIVER CT ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| CATHERINE LISA LUKE3 | 4787 W. HACIENDA AVE CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| ANTONIO JOSE ANGELES3 | 1858 ALLISON WAY SAN JOSE, CA 95132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $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 | 96 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 68 | $797K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 97 | $58K |
| Vision | VISION SERVICE PLAN | 46 | $8K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 97 | $58K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 8 | $5K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 97 | $58K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 68 | $797K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 97 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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."
No prospect flags tripped on this filing.