| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 46082 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 0.75% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 945493958 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 0.44% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 85018 | DELTA DENTAL OF ARIZONA | $3K | — | $3K | 3.34% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES INC. | 3470 MT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94549 | DELTA DENTAL OF ARIZONA | $2K | — | $2K | 1.66% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 3.29% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94543 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $613 | — | $613 | 1.70% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 8201 NORTH HAYDEN ROAD SCOTTSDALE, AZ 85258 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $886 | — | $886 | 3.34% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MOUNT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94543 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $439 | — | $439 | 1.66% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TEXAS HIGHWAY SOUTH BUILDING II SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $258 | $258 | 0.97% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP PROPERTY & CASUALTY SERVICES | 8201 NORTH HAYDEN ROAD SCOTTSDALE, AZ 85258 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 3430 CARMEL, IN 46082 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $415 | — | $415 | 3.36% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94543 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $202 | — | $202 | 1.64% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TEXAS HIGHWAY SOUTH BUILDING II SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $107 | $107 | 0.87% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP PROPERTY & CASUALTY SERVICES | 8201 NORTH HAYDEN ROAD SCOTTSDALE, AZ 85258 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $79 | — | $79 | 3.31% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94543 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $40 | — | $40 | 1.68% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 CAPITAL OF TEXAS HIGHWAY SOUTH BUILDING II SUITE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $26 | $26 | 1.09% |
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 | 280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 138 | $528K |
| Dental | DELTA DENTAL OF ARIZONA | 200 | $102K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 178 | $25K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 291 | $36K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 150 | $12K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $27K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 291 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.