| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEWIS & KESMODEL INSURANCE SERVICES | 900 HOWE AVENUE SUITE 220 SACRAMENTO, CA 95825 | KAISER FOUNDATION HEALTH PLAN, INC. | $11K | $0 | $11K | 0.98% |
| LEWIS & KESMODEL INSURANCE SERVICES | 900 HOWE AVENUE SUITE 220 SACRAMENTO, CA 95825 | SUTTER HEALTH PLAN | $17K | $0 | $17K | 5.00% |
| LEWIS & KESMODEL INSURANCE SERVICES | 900 HOWE AVENUE SUITE 220 SACRAMENTO, CA 95825 | THE GUARDIAN LIFE INSURANCE COMPANY | $6K | — | $6K | 3.97% |
| PACIFIC ADVISORS LLC Filed as: PACIFIC ADVISORS, LLC | 333 INDIAN HILL BLVD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY | $221 | — | $221 | 0.15% |
| LEWIS & KESMODEL INSURANCE SERVICES | 900 HOWE AVENUE SUITE 220 SACRAMENTO, CA 95825 | THE LINCOLN NATIONAL LIFE INSURANCE CO | $3K | — | $3K | 15.00% |
| LEWIS & KESMODEL INSURANCE SERVICES | 900 HOWE AVENUE SUITE 220 SACRAMENTO, CA 95825 | THE LINCOLN NATIONAL LIFE INSURANCE CO | $2K | — | $2K | 15.00% |
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 | 229 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 176 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 196 | $146K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 196 | $146K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE CO | 229 | $20K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE CO | 229 | $15K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 176 | $1.5M |
| Other(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE CO | 229 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.