| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | BLUE CROSS OF CALIFORNIA | $74K | $0 | $74K | 3.71% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2121 N CALIFORNIA BLVD SUITE 1000 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $65K | $3 | $65K | 3.99% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $240 | $240 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $10K | $0 | $10K | 3.97% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2121 N CALIFORNIA BLVD SUITE 1000 WALNUT CREEK, CA 94596 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $19K | $0 | $19K | 11.51% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $3K | $3K | 1.60% |
| LEWIS MILTON KELLEY3 | 20645 N PIMA ROAD SUITE 150 SCOTTSDALE, AZ 85255 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 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 | 373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 229 | $3.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 300 | $252K |
| Vision | VISION SERVICE PLAN | 302 | $90K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 307 | $193K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 307 | $169K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 307 | $169K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 229 | $3.6M |
| Other(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 320 | $172K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.