| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 3.69% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.30% |
| ASCENSION INSURANCE AGENCY3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $773 | — | $773 | 0.11% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | AMERITAS LIFE INSURANCE CORP. | $467 | $36 | $503 | 7.89% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA. | 1277 TREAT BOULEVARD, SUITE 100 WALNUT CREEK, CA 94597 | AMERITAS LIFE INSURANCE CORP. | $171 | — | $171 | 2.68% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $173 | $51 | $224 | 10.78% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 100 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $35 | — | $35 | 1.69% |
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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 87 | $694K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 114 | $6K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $2K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 87 | $694K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.