| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC. | $156K | — | $156K | 3.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | GUARDIAN | $45K | $10K | $55K | 6.70% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $17K | — | $17K | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.36% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 2.48% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $8K | — | $8K | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $8K | — | $8K | 7.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 8.83% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.11% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKALAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 2.96% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 7.40% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.23% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 3.53% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$345 | — | -$345 | -0.77% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $3K | — | $3K | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $2K | — | $2K | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKALAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $500 | — | $500 | 2.10% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $790 | — | $790 | 3.36% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $388 | — | $388 | 1.65% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 5.98% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$290 | — | -$290 | -1.55% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $645 | — | $645 | 4.43% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $115 | — | $115 | 0.79% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $899 | — | $899 | 6.35% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $701 | — | $701 | 4.95% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $556 | — | $556 | 6.63% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $336 | — | $336 | 4.01% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 511398 LOS ANGELES, CA 90051 | AMERICAN FIDELITY ASSURANCE COMPANY | $326 | — | $326 | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $311 | — | $311 | 4.77% |
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 | 948 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 954 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,191 | $5.7M |
| Dental(6 contracts, 2 carriers) | GUARDIAN | 948 | $1.4M |
| Vision | GUARDIAN | 948 | $817K |
| Life insurance | GUARDIAN | 948 | $817K |
| Short-term disability(12 contracts, 2 carriers) | GUARDIAN | 948 | $1.2M |
| Long-term disability(12 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 68 | $442K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 1,191 | $5.2M |
| Other(13 contracts, 2 carriers) | GUARDIAN | 948 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,191 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.