| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $55K | $3K | $58K | 2.48% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | ANTHEM BLUE CROSS AND BLUE SHIELD | $48K | $2K | $50K | 2.44% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $2K | $14K | 11.57% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | DELTA DENTAL OF CALIFORNIA | $7K | — | $7K | 10.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $122 | $6K | 9.98% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD STE 400 GRANITE BAY, CA 95746 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.98% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $294 | — | $294 | 0.48% |
| MACE, PETER, J3 | STE 500 3350 RIVERWOOD PARKWAY 80 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $249 | — | $249 | 0.40% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 5668 CONCORD, CA 94524 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $951 | $6K | 11.80% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $238 | $6K | 11.61% |
| MACE, PETER, J3 | 3350 RIVERWOOD PARKWAY 80 STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.99% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD STE 400 GRANITE BAY, CA 95746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $989 | — | $989 | 1.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $409 | — | $409 | 0.79% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 3.65% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $77 | $1K | 2.67% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | DELTA DENTAL OF CALIFORNIA | $11K | — | $11K | 23.27% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $353 | $2K | 11.74% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 123 MISSION ST 26TH FLOOR SAN FRANCISCO, CA 94105 | MANAGED HEALTH NETWORK | $965 | — | $965 | 5.00% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFIT PROGRAMS AN | AON COMPANY 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 2.08% |
| KELLEY AND SWAIN, INC3 Filed as: KELLEY & SWAIN INC | 123 MISSION ST 26TH FLOOR SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.29% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH | CUSTOM BENEFITS PROGRAMS INC 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.19% |
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 | 737 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 745 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 365 | $4.4M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 771 | $118K |
| Vision | VISION SERVICE PLAN | 479 | $52K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 715 | $171K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 148 | $52K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 737 | $53K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 365 | $2.4M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 839 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 839 | — |
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.