| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN, INC. | $32K | $0 | $32K | 3.24% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | CALIFORNIA PHYSICIANS SERVICE | $0 | $36K | $36K | 4.17% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | PO BOX 255188 SACRAMENTO, CA 95865 | STANDARD INSURANCE COMPANY | $9K | $0 | $9K | 3.14% |
| JAMES A. BULOTTI3 Filed as: JAMES BULOTTI | 3636 AMERICAN RIVER DRIVE SACRAMENTO, CA 95864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 26.24% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $122 | $0 | $122 | 4.01% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 127 | $1.9M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 160 | $289K |
| Long-term disability | STANDARD INSURANCE COMPANY | 160 | $286K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 127 | $1.9M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 160 | $296K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.