| 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. | $92K | $2K | $93K | 2.87% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | ONE VENTURE, SUITE 220 IRVINE, CA 92618 | GUARDIAN | $26K | $13K | $39K | 9.96% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 5.88% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 4.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.65% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.13% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $7K | — | $7K | 7.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 13.31% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.91% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 13.94% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 4.86% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $2K | — | $2K | 7.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 9.55% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 4.94% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $9K | — | $9K | 46.43% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $988 | — | $988 | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | SIMNSA HEALTH PLAN | $416 | — | $416 | 7.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $209 | — | $209 | 5.01% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | -$1K | — | -$1K | -32.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $184 | — | $184 | 5.01% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKALAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$967 | — | -$967 | -26.31% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 55.08% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | AMERICAN FIDELITY ASSURANCE COMPANY | $114 | — | $114 | 3.49% |
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 | 532 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 534 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 632 | $3.4M |
| Dental(4 contracts, 2 carriers) | GUARDIAN | 532 | $524K |
| Vision | GUARDIAN | 532 | $391K |
| Life insurance | GUARDIAN | 532 | $391K |
| Short-term disability(9 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 94 | $355K |
| Long-term disability(9 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 94 | $355K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 632 | $3.3M |
| Other(10 contracts, 2 carriers) | GUARDIAN | 532 | $746K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 632 | — |
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.