| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBA PREMIER INSURANCE SOLUTIONS3 | 2033 GATEWAY PL SAN JOSE, CA 95110 | AETNA LIFE INSURANCE COMPANY | $32K | $0 | $32K | 3.94% |
| CORPORATE BENEFIT ADVISORS3 Filed as: CORPORATE BENEFIT ADVISORS, INC. | 2033 GATEWAY PL STE 500 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $22K | $0 | $22K | 3.77% |
| CBA PREMIER INSURANCE SOLUTIONS3 Filed as: CBA PREMIER INSURANCE SOLUTION | 2033 GATEWAY PLACE STE 500 SAN JOSE, CA 95110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $3K | $14K | 3.32% |
| CBA PREMIER INSURANCE SOLUTIONS3 | 2033 GATEWAY PL SAN JOSE, CA 95110 | AETNA HEALTH, INC. | $16K | $0 | $16K | 4.08% |
| CBA PREMIER INSURANCE SOLUTIONS3 Filed as: CBA PREMIER INSURANCE SOLUTIONS INC | 2033 GATEWAY PLACE SUITE 500 SAN JOSE, CA 95110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $11K | $0 | $11K | 7.44% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | 12404 PARK CENTRAL DRIVE SUITE 400 S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $7K | $7K | 4.96% |
| CBA PREMIER INSURANCE SOLUTIONS3 Filed as: CBA PREMIER INSURANCE SOLUTION | 2033 GATEWAY PLACE STE 500 SAN JOSE, CA 95110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $0 | $20K | 15.00% |
| CBA PREMIER INSURANCE SOLUTIONS3 | 2033 GATEWAY PL STE 500 SAN JOSE, CA 95110 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.34% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 69 | $1.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 125 | $144K |
| Vision | VISION SERVICE PLAN | 127 | $21K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $428K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $428K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 67 | $573K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $560K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.