| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUHR RISK SERVICES3 | 5300 STEVENS CREEK BLVD. SAN JOSE, CA 95129 | KAISER FOUNDATION HEALTH PLAN INC. | $23K | — | $23K | 2.24% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 1.30% |
| SUHR RISK SERVICES3 | 5300 STEVENS CREEK BLVD. SAN JOSE, CA 95129 | VISION SERVICE PLAN | $762 | — | $762 | 3.32% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | VISION SERVICE PLAN | $432 | — | $432 | 1.88% |
| SUHR RISK SERVICES3 | 5300 STEVENS CREEK BLVD. SAN JOSE, CA 95129 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 9.99% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | STANDARD INSURANCE COMPANY | $463 | — | $463 | 2.64% |
| SUHR RISK SERVICES3 | 5300 STEVENS CREEK BLVD. SAN JOSE, CA 95129 | STANDARD INSURANCE COMPANY | $883 | — | $883 | 6.02% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | STANDARD INSURANCE COMPANY | $358 | — | $358 | 2.44% |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 231 | $1.0M |
| Vision | VISION SERVICE PLAN | 177 | $23K |
| Life insurance | STANDARD INSURANCE COMPANY | 186 | $15K |
| Long-term disability | STANDARD INSURANCE COMPANY | 186 | $18K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 231 | $1.0M |
| Other | STANDARD INSURANCE COMPANY | 186 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.