| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $21K | — | $21K | 4.39% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2677 N MAIN ST, STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 1.56% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | $664 | $13K | 10.45% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER ST., SUITE 300 ORANGE, CA 92868 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 3.49% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 12.75% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.07% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $302 | — | $302 | 11.14% |
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 | 98 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 76 | $474K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 100 | $126K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 100 | $126K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 98 | $14K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 98 | $21K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 76 | $474K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 98 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.