| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET, SUITE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC. | $107K | $5 | $107K | 2.78% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | ONE VENTURE, SUITE 220 IRVINE, CA 92618 | GUARDIAN | $33K | — | $33K | 5.88% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.56% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $384 | — | $384 | 0.33% |
| 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% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $8K | — | $8K | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.69% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 1.29% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.63% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKALAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $101 | — | $101 | 0.32% |
| 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 102159 PASADENA, CA 91189 | 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 | $639 | — | $639 | 2.70% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 16.46% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 4.53% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $810 | — | $810 | 4.67% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $302 | — | $302 | 1.74% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $798 | — | $798 | 5.36% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $239 | — | $239 | 1.61% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $958 | — | $958 | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $619 | — | $619 | 4.87% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | -$661 | — | -$661 | -5.20% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $428 | — | $428 | 3.94% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$48 | — | -$48 | -0.44% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 15.50% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $675 | — | $675 | 8.10% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $338 | — | $338 | 4.79% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$772 | — | -$772 | -10.95% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $93 | — | $93 | 4.49% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$381 | — | -$381 | -18.38% |
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 | 592 | 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) | 593 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 745 | $4.2M |
| Dental(6 contracts, 2 carriers) | GUARDIAN | 592 | $944K |
| Vision | GUARDIAN | 592 | $562K |
| Life insurance | GUARDIAN | 592 | $562K |
| Short-term disability(13 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 77 | $405K |
| Long-term disability(13 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 77 | $405K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 745 | $3.9M |
| Other(14 contracts, 2 carriers) | GUARDIAN | 592 | $967K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 745 | — |
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.