| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING | P.O BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION OF HEALTH PLAN INC. | $26K | — | $26K | 3.79% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5668 CONCORD, CA 94524 | KAISER FOUNDATION OF HEALTH PLAN INC. | $8K | — | $8K | 1.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 3247 W. MARCH LANE STOCKTON, CA 95219 | PREMIER ACCESS INSURANCE COMPANY | $3K | — | $3K | 6.64% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1743 CREEKSIDE DRIVE, SUITE 200 FOLSOM, CA 95630 | PREMIER ACCESS INSURANCE COMPANY | $510 | — | $510 | 1.03% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $351 | $7K | 30.54% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 2021 W. MARCH LANE STOCKTON, CA 95207 | VISION SERVICE PLAN | $629 | — | $629 | 6.34% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD CONCORD, CA 94520 | VISION SERVICE PLAN | $117 | — | $117 | 1.18% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION OF HEALTH PLAN INC. | 157 | $683K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 117 | $50K |
| Vision | VISION SERVICE PLAN | 81 | $10K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 32 | $22K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 32 | $22K |
| Prescription drug | KAISER FOUNDATION OF HEALTH PLAN INC. | 157 | $683K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 32 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.