| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC | P.O. BOX 123042 DALLAS, TX 753123042 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $36K | $36K | 2.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMIN | Other services; Named fiduciary; Direct payment from the plan; Contract Administrator; Claims processing; Non-monetary compensation; Float revenue; Participant communication Service code 12 | — | $1.0M |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMIN | Other services; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $245K |
| BEST DOCTORS, INC. EIN 04-2908444 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Other services Service code 13 | — | $112K |
| PAYFLEX SYSTEMS USA, INC. EIN 91-1774434 CONTRACT ADMIN | Claims processing Service code 12 | — | $18K |
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 | 3,794 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 195 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,989 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 4,512 | $26.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 4,034 | $4.7M |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,973 | $26.5M |
| Life insurance | AETNA INTERNATIONAL | 7 | $129K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 1,973 | $26.4M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,070 | $1.7M |
| Other | CIGNA HEALTH AND LIFE INSURANCE CO. AND AFFILIATES | 4,512 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,512 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.