| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS. SVCS. | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | KAISER FOUNDATION HEALTH PLAN, INC. | $25K | $0 | $25K | 3.62% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $0 | $12K | 1.66% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS. SVCS. | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | CYPRESS DENTAL ADMINISTRATORS | $7K | $0 | $7K | 5.31% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | CYPRESS DENTAL ADMINISTRATORS | $1K | $0 | $1K | 0.80% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS. SVCS. | 1425 RIVER PARK DRIVE, SUITE 226 SACRAMENTO, CA 95815 | CALIFORNIA PHYSICIANS SERVICE | $4K | $0 | $4K | 3.21% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICE | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | $0 | $2K | $2K | 1.88% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS SERVICE | $2K | $0 | $2K | 1.79% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF CALIFORNIA | PO BOX 1388 VENTURA, CA 93002 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 8.74% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 139 | $816K |
| Dental | CYPRESS DENTAL ADMINISTRATORS | 134 | $125K |
| Vision | CYPRESS DENTAL ADMINISTRATORS | 134 | $125K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 154 | $38K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 139 | $816K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 154 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.