| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | AETNA LIFE INSURANCE CO. | $130K | — | $130K | 2.95% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | SUN LIFE ASSURANCE COMPANY OF CANADA | $21K | — | $21K | 4.50% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | AETNA HEALTH, INC | $11K | — | $11K | 3.04% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA BENEFITS GROUP | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 1.83% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD STE 200 MOUNTAIN VIEW, CA 94040 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 1.30% |
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $11K | $27K | 17.23% |
| M FINANCIAL HOLDINGS INC3 | 1125 NM COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 1.24% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 4.50% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD SUITE MOUNTAIN VIEW, CA 94040 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 3.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 1451 GRANT ROAD SUITE 200 MOUNTAIN VIEW, CA 94040 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19K | $0 | $19K | 22.46% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $17K | $17K | 20.66% |
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $5K | $14K | 22.56% |
| M FINANCIAL HOLDINGS INC3 | 1125 NM COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 1.97% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES, INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | VISION SERVICE PLAN | $1K | — | $1K | 4.45% |
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $444 | $244 | $688 | 12.42% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH STREET SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $59 | $59 | 1.07% |
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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 385 | $4.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 461 | $280K |
| Vision | VISION SERVICE PLAN | 167 | $33K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMAPNY | 167 | $476K |
| Long-term disability(5 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $776K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.