| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $53K | — | $53K | 2.49% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | CALIFORNIA PHYSICIANS SERVICE | $53K | $61 | $53K | 2.50% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 3.10% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 10.00% |
| VERSUS INSURANCE SERVICES LLC3 Filed as: VERSUS INSURANCE SERVICES | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 11.11% |
| PETER J MACE3 | 5775 E GLENRIDGE DR, SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.21% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD, SUITE 800 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.85% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | DELTA DENTAL OF CALIFORNIA | $7K | — | $7K | 10.00% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | VISION SERVICE PLAN | $2K | — | $2K | 3.16% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 2.50% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 10.00% |
| VERSUS INSURANCE SERVICES LLC3 Filed as: VERSUS INSURANCE SERVICES | 6085 DOUGLAS BLVD, SUITE 400 GRANITE BAY, CA 95746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | — | $14K | 24.25% |
| PETER J MACE3 | 5775 E GLENRIDGE DR, SUITE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.27% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD, SUITE 800 CONCORD, CA 94520 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $541 | — | $541 | 0.94% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| VERSUS INSURANCE SERVICES LLC3 Filed as: VERSUS INSURANCE SERVICES | 6085 DOUGLAS BLVD., SUITE 400 GRANITE BAY, CA 95746 | MANAGED HEALTH NETWORK | $1K | — | $1K | 5.00% |
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 | 790 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 142 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 932 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 379 | $4.3M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 494 | $456K |
| Vision | VISION SERVICE PLAN | 606 | $67K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 790 | $207K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 181 | $57K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 793 | $63K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 379 | $4.3M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 874 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 874 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.