| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS, INC. | 10011 N. FOOTHILL BLVD., STE 110 CUPERTINO, CA 95014 | KAISER FOUNDATION HEALTH PLANS INC. | $23K | — | $23K | 3.39% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFIT SVCS, INC. | 10011 N. FOOTHILL BLVD., STE 110 CUPERTINO, CA 95014 | CALIFORNIA PHYSICIANS SERVICE | $9K | — | $9K | 3.00% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS INC. | 10011 N FOOTHILL BLVD. STE 110 CUPERTINO, CA 95014 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 9.90% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SERVICES INC. | DEPT 2075, P.O. BOX 29675 PHOENIX, AZ 85038 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $6K | $6K | 4.96% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS DBA KLEINBERG BENEFITS INC. INS | 10011 N FOOTHILL BLVD STE 110 CUPERTINO, CA 95014 | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 3.00% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS INC. | 96 | $956K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 108 | $122K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY | 120 | $54K |
| Other | BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY | 120 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.