| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 1039 NORTH MCDOWELL BOULEVARD SUITE A PETALUMA, CA 94954 | KAISER FOUNDATION HEALTH PLAN INC | $56K | — | $56K | 1.84% |
| WELLS FARGO INSURANCE SERVICES3 | 1039 NORTH MCDOWELL BOULEVARD SUITE A PETALUMA, CA 94954 | HEALTH NET | $58K | — | $58K | 3.98% |
| WELLS FARGO INSURANCE SERVICES3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIANS SERVICE | $4K | — | $4K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 18TH FLOOR SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 | 3800 CENTERPOINT DRIVE, SUITE 540 ANCHORAGE, AK 99503 | METROPOLITAN LIFE INSURANCE COMPANY | — | $391 | $391 | 2.00% |
| WELLS FARGO INSURANCE SERVICES3 | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIANS SERVICE | $514 | — | $514 | 5.00% |
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 | 512 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 542 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 415 | $4.6M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 5 | $43K |
| Vision(2 contracts) | CALIFORNIA PHYSICIANS SERVICE | 111 | $53K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 497 | $20K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 415 | $4.6M |
| Other(2 contracts, 2 carriers) | MHN | 683 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 683 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.