| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | KAISER FOUNDATION HEALTH PLAN REGION CA | $107K | $0 | $107K | 5.03% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | WESTERN HEALTH ADVANTAGE | $92K | $0 | $92K | 5.00% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 12.87% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.27% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | ANTHEM BLUE CROSS | $4K | $0 | $4K | 7.07% |
| AMWINS3 Filed as: LISI | 1600 W HILLSDALE BLVD. SAN MATEO, CA 94403 | ANTHEM BLUE CROSS | $0 | $2K | $2K | 3.53% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | PREMIER ACCESS INSURANCE COMPANY | $6K | $0 | $6K | 21.79% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 10.33% |
| INTEGRATED BENEFITS & INS SERV INC3 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | METROPOLITAN LIFE INSURANCE COMPANY | $557 | $0 | $557 | 13.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTEGRATED BENEFITS & INS SERV INC EIN 94-2850278 BROKER | Insurance agents and brokers Service code 22 | 1831 IRON POINT ROAD #100 FOLSOM, CA 95630 | $0 |
| LISI EIN 94-2757978 GENERAL AGENT | Insurance agents and brokers Service code 22 | 1600 W HILLSDALE BOVD SAN MATEO, CA 94403 | $0 |
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 | 637 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 654 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN REGION CA | 412 | $4.0M |
| Dental(2 contracts) | PREMIER ACCESS INSURANCE COMPANY | 814 | $46K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 364 | $67K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 637 | $120K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 637 | $120K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN REGION CA | 412 | $4.0M |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 637 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 814 | — |
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.