| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $52K | — | $52K | 4.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 0.42% |
| MICHAEL B BRIARE3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | HUMANA INSURANCE COMPANY | $10K | — | $10K | 1.74% |
| TEVIS INSURANCE SOLUTIONS3 | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 0.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC. | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GEORGE WRIGHT | 1466 N HIGHWAY 89, SUITE 240 FARMINGTON, UT 84025 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 14.93% |
| MICHAEL B BRIARE3 Filed as: MICHAEL BRIARE | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | SAFEGUARD HEALTH PLANS, INC. | $367 | — | $367 | 941.03% |
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 | 436 | 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) | 437 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 436 | $1.7M |
| Dental | SAFEGUARD HEALTH PLANS, INC. | 0 | $39 |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 69 | $14K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 436 | $1.7M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 69 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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.