| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $58K | $918 | $59K | 2.72% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | ANTHEM BLUE CROSS AND BLUE SHIELD | $50K | $7K | $57K | 2.96% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 10.79% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $37 | $2K | 2.53% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INSURANCE | PO BOX 5668 CONCORD, CA 94524 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 10.80% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $205 | $8K | 14.33% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD SUITE 400 GRANITE BAY, CA 95746 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $560 | — | $560 | 0.96% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26 | — | $26 | 0.04% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23 | — | $23 | 0.04% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | DELTA DENTAL OF CALIFORNIA | $6K | — | $6K | 10.55% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 3.85% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $159 | $4K | 9.17% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $942 | — | $942 | 2.04% |
| VERUS INSURANCE SERVICES, LLC3 Filed as: VERUS INSURANCE SERVICES | 6085 DOUGLAS BLVD SUITE 400 GRANITE BAY, CA 95746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $500 | — | $500 | 1.08% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $380 | — | $380 | 0.82% |
| 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 | $3K | — | $3K | 10.78% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 123 MISSION ST 26TH FLOOR SAN FRANCISCO, CA 94105 | MANAGED HEALTH NETWORK | $803 | — | $803 | 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 | 654 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 675 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 305 | $4.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 718 | $98K |
| Vision | VISION SERVICE PLAN | 430 | $47K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 915 | $188K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 130 | $46K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 654 | $65K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 305 | $2.2M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 722 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 915 | — |
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."
No prospect flags tripped on this filing.