| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AETNA LIFE INSURANCE COMPANY | $11K | $26K | $37K | 4.31% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $0 | $8K | 5.00% |
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BEN. INS. SVCS. LLC | PO BOX 1749 GILROY, CA 95021 | KAISER FOUNDATION HEALTH PLAN, INC. | -$34 | $0 | -$34 | -0.02% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $0 | $2K | 3.44% |
| LOCKTON COMPANIES, LLC3 | 400 CAPITOL MALL, SUITE 2600 SACRAMENTO, CA 95814 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $236 | $0 | $236 | 0.50% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.06% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | PO BOX 460940 PAPILLION, NE 68046 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.35% |
| PACIFIC COAST BENEFITS, LLC3 Filed as: PACIFIC COAST BEN. INS. SVCS. LLC | PO BOX 1749 GILROY, CA 95021 | PRINCIPAL LIFE INSURANCE COMPANY | $856 | $0 | $856 | 5.25% |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 162 | $1.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 162 | $852K |
| Vision | AETNA LIFE INSURANCE COMPANY | 162 | $852K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 164 | $16K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 164 | $868K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.