| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | — | $5K | $5K | 0.04% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | — | $836 | $836 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 95-4331852 NONE | Float revenue; Other fees; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $1.3M |
| DELTA DENTAL PLAN OF CALIFORNIA EIN 94-1461312 NONE | Claims processing Service code 12 | — | $270K |
| MORNEAU SHAPELL EIN 41-1981625 NONE | Contract Administrator Service code 13 | — | $220K |
| BARNEY & BARNEY, LLC EIN 95-2156846 NONE | Insurance agents and brokers Service code 22 | — | $157K |
| CONEXIS EIN 20-0198855 NONE | Claims processing Service code 12 | — | $56K |
| BPM LLC EIN 81-4234542 NONE | Accounting (including auditing) Service code 10 | — | $22K |
| LOREN MYERS & ASSOCIATES EIN 95-3879885 NONE | Other services Service code 49 | — | $17K |
| RENGER CORPORATION EIN 27-0290605 NONE | Other services Service code 49 | — | $7K |
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 | 3,204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 99 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 3,236 | $14.9M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 1 | $21K |
| Vision | VISION SERVICE PLAN | 2,637 | $486K |
| Life insurance | STANDARD INSURANCE COMPANY | 3,210 | $2.0M |
| Short-term disability | STANDARD INSURANCE COMPANY | 3,204 | $1.1M |
| Long-term disability | STANDARD INSURANCE COMPANY | 3,205 | $1.2M |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,591 | $14.8M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 875 | $1.6M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 3,236 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,236 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.