| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | KAISER FOUNDATION HEALTH PLAN, INC. | $35K | $0 | $35K | 4.59% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 500 SILVER SPUR ROAD, SUITE 121 ROLLING HILLS ESTATES, CA 90275 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $882 | $2K | 14.59% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. AND FINANCIAL SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 6.34% |
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 | 290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 102 | $758K |
| Dental | CALIFORNIA DENTAL NETWORK, INC. | 93 | $0 |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 313 | $17K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 313 | $17K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 102 | $758K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 313 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.