| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $9K | $0 | $9K | 1.89% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 1.33% |
| USI INSURANCE SERVICES LLC3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 5.21% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | PREMIER ACCESS INSURANCE COMPANY | $1K | $0 | $1K | 3.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $697 | $0 | $697 | 6.62% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 1435 NORTH MCDOWELL BOULEVARD SUITE 310 PETALUMA, CA 94954 | SUN LIFE ASSURANCE COMPANY OF CANADA | $356 | $0 | $356 | 3.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1039A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | MANAGED HEALTH NETWORK | $179 | $0 | $179 | 2.85% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | MANAGED HEALTH NETWORK | $135 | $0 | $135 | 2.15% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 27 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 63 | $487K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 94 | $38K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 122 | $11K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 122 | $11K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 63 | $487K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.