| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 75004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $74K | $0 | $74K | 9.30% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 0.80% |
| JACK NIXON3 | 755 DEER VALLEY ROAD SAN RAFAEL, CA 94903 | KAISER FOUNDATION HEALTH PLAN INC | -$62K | $0 | -$62K | -7.76% |
| JACK NIXON3 | 755 DEER VALLEY ROAD SAN RAFAEL, CA 94903 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 1.04% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 0.76% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 75004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 0.45% |
| JACK NIXON3 | 755 DEER VALLEY ROAD SAN RAFAEL, IL 94903 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 12.76% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $137 | $4K | 7.51% |
| JACK NIXON3 | 755 DEER VALLEY ROAD SAN RAFAEL, IL 94903 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.88% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $38 | $1K | 7.39% |
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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 93 | $1.4M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 222 | $14K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 222 | $51K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 93 | $1.4M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 222 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.