| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | 310 HEMSTED DRIVE, SUITE 200 REDDING, CA 96002 | CALIFORNIA PHYSICIANS SERVICE | $0 | $38K | $38K | 4.06% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MOUNT DIABLO BOULEVARD SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | $0 | $14K | 4.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 3697 MOUNT DIABLO BOULEVARD SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN, INC. | $220 | $0 | $220 | 0.07% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SVCS LLC | PO BOX 255188 SACRAMENTO, CA 95865 | HUMANA INSURANCE COMPANY | $3K | $1K | $4K | 5.09% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SVCS. LLC | PO BOX 8110 CHICO, CA 95927 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.14% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $487 | $0 | $487 | 1.25% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SVCS LLC | PO BOX 255188 SACRAMENTO, CA 95865 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| ART JETTER AND COMPANY3 Filed as: ART JETTER & COMPANY | 11301 DAVENPORT ST OMAHA, NE 68154 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 119 | $1.2M |
| Dental | HUMANA INSURANCE COMPANY | 109 | $84K |
| Vision | VISION SERVICE PLAN | 111 | $39K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $32K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $32K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 119 | $1.2M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.