| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 606017604 | KAISER FOUNDATION HEALTH PLAN | $135K | — | $135K | 2.99% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES, USA | 10940 WHITE ROCK RD RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIAN'S SERVICE | $104K | $1K | $105K | 5.05% |
| WELLS FARGO INSURANCE SERVICES3 | 150 N MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASURANCE COMPANY OF BOSTON | $26K | $948 | $27K | 11.05% |
| WELLS FARGO INSURANCE SERVICES3 | 10940 WHITE ROCK RD RANCHO CORDOVA, CA 95670 | GERBER LIFE INSURANCE CO. | $1K | — | $1K | 6.76% |
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 | 630 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 630 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 757 | $6.6M |
| Vision | GERBER LIFE INSURANCE CO. | 175 | $21K |
| Life insurance | LIBERTY LIFE ASURANCE COMPANY OF BOSTON | 630 | $243K |
| Short-term disability | LIBERTY LIFE ASURANCE COMPANY OF BOSTON | 630 | $243K |
| Long-term disability | LIBERTY LIFE ASURANCE COMPANY OF BOSTON | 630 | $243K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN | 757 | $6.6M |
| Other | LIBERTY LIFE ASURANCE COMPANY OF BOSTON | 630 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 757 | — |
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.