| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | KAISER FOUNDATION HEALTH PLAN INC | $80K | — | $80K | 1.98% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDEPOINT PARKEWAY BUILDING 3 #500 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $38K | — | $38K | 12.02% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | TRANSAMERICA LIFE INSURANCE COMPANY | $18K | — | $18K | 5.73% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $28K | — | $28K | 9.63% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | SUTTER HEALTH PLAN | $12K | — | $12K | 5.00% |
| CRYSTAL IBC LLC3 | 575 MARKET ST STE #3600 SAN FRANCISCO, CA 94105 | CHINESE COMMUNITY HEALTH PLAN | $4K | — | $4K | 5.09% |
| CRYSTAL IBC LLC3 | 32 OLD SLIP NEW YORK, NY 10005 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.25% |
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 | 622 | 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) | 622 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 552 | $4.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 529 | $295K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 529 | $295K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 622 | $81K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 622 | $81K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 552 | $4.3M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,589 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,589 | — |
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.