| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $34K | — | $34K | 4.61% |
| HEFFERNAN INSURANCE BROKERS3 Filed as: HEFFERNAN INS BROKERS | 44 MONTGOMERY ST SUITE 1950 SAN FRANCISCO, CA 94104 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $30K | — | $30K | 4.12% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SRVC LLC | 900 EAST HAMILTON AVE SUITE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $6K | — | $6K | 0.83% |
| HEFFERNAN INSURANCE BROKERS3 | 44 MONTGOMERY ST SUITE 1950 SAN FRANCISCO, CA 94104 | STANDARD INSURANCE COMPANY | $2K | $523 | $2K | 9.67% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SERVICE LLC | 900 EAST HAMILTON AVE SUITE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $401 | — | $401 | 1.66% |
| HEFFERNAN INSURANCE BROKERS3 Filed as: HEFFERNAN INS BROKERS | PO BOX 4006 WALNUT CREEK, CA 94596 | RELIANCESTANDARD | $719 | — | $719 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 900 EAST HAMILTON AVE SUITE 500 CAMPBELL, CA 95008 | RELIANCESTANDARD | $360 | — | $360 | 5.00% |
| HEFFERNAN INSURANCE BROKERS3 Filed as: HEFFERNAN INS BROKERS | PO BOX 4006 WALNUT CREEK, CA 94596 | RELIANCESTANDARD | $361 | — | $361 | 9.99% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 900 EAST HAMILTON AVE SUITE 500 CAMPBELL, CA 95008 | RELIANCESTANDARD | $181 | — | $181 | 5.01% |
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 | 399 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 355 | $1.6M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 355 | $729K |
| Vision | VISION SERVICE PLAN | 172 | $14K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 399 | $31K |
| Short-term disability | STANDARD INSURANCE COMPANY | 399 | $24K |
| Long-term disability | RELIANCESTANDARD | 12 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 399 | — |
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.