| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SVCS LLC3 | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | BLUE CROSS OF CALIFORNIA | $72K | — | $72K | 3.95% |
| INTERNATIONAL PROINSURANCE SVCS LLC3 | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN INC | $66K | — | $66K | 4.94% |
| INTERNATIONAL PROINSURANCE SVCS LLC3 | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 2.32% |
| INTERNATIONAL PROINSURANCE SVCS LLC3 | PO BOX 2540 MENLO PARK, CA 94025 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 7.73% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $103 | $103 | 0.10% |
| INTERNATIONAL PROINSURANCE SVCS LLC3 | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | VISION SERVICE PLAN | $2K | — | $2K | 4.09% |
| INTERNATIONAL PROINSURANCE SVCS LLC3 | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $539 | — | $539 | 8.76% |
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 | 313 | 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) | 313 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 280 | $3.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 580 | $286K |
| Vision | VISION SERVICE PLAN | 321 | $40K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 313 | $101K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 313 | $101K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 280 | $3.2M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 313 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 580 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.