| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE ROCKLIN, CA 95677 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | — | $13K | 2.54% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2677 N MAIN STREET, SUITE 800 SANTA ANA, CA 927056687 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 970 RESERVE DRIVE ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | — | $11K | 2.04% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE ROCKLIN, CA 95677 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 1.85% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE ROCKLIN, CA 95677 | PREMERA BLUE CROSS | $6K | — | $6K | 3.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | PREMERA BLUE CROSS | $3K | — | $3K | 1.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 6565 AMERICAS PKWY ALBUQUERQUE, NM 87110 | BLUE CROSS BLUE SHIELD OF ARIZONA | $5K | — | $5K | 3.47% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | 2677 N MAIN STREET SANTA ANA, CA 92705 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | — | $2K | 1.59% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS | 970 RESERVE DRIVE, SUITE 200 ROSEVILLE, CA 95678 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $2K | $5K | 5.64% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 2600 KELLY ROAD WARRINGTON, PA 18976 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.68% |
| CLIFFORD BENEFITS GROUP3 | 4465 GRANITE DRIVE ROCKLIN, CA 95677 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 3.53% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 88 | $1.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 142 | $81K |
| Vision(2 contracts, 2 carriers) | PREMERA BLUE CROSS | 142 | $260K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 142 | $81K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 88 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.