| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN INC | $7K | $2K | $9K | 1.35% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 150 SAWGRASS DR ROCHESTER, NY 146204648 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 0.99% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET 21ST FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $2K | — | $2K | 2.83% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DR ROCHESTER, NY 14623 | UNITED CONCORDIA INSURANCE CENTER | $3K | $166 | $4K | 6.36% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 115 NORTH EL MOLINO AVE PASADENA, CA 91101 | UNITED CONCORDIA INSURANCE CENTER | $2K | $465 | $3K | 4.76% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST SUITE 2400 SAN FRANCISCO, CA 94101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $775 | — | $775 | 1.66% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY, INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $592 | — | $592 | 1.27% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $747 | — | $747 | 7.68% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST FL 24 SAN FRANCISCO, CA 94104 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $712 | — | $712 | 7.32% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY, INC | 150 SAWGRASS DR ROCHESTER, NY 14623 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $265 | $13 | $278 | 6.32% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 115 NORTH EL MOLINO AVE PASADENA, CA 91101 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $178 | $37 | $215 | 4.89% |
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 | 118 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 132 | $787K |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE CENTER | 107 | $60K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $10K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 132 | $787K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
No prospect flags tripped on this filing.