| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | KAISER FOUNDATION HEALTH PLAN, INC. | $41K | $0 | $41K | 4.19% |
| PINNACLE BROKERS3 Filed as: PINNACLE BROKERS INSURANCE SOLUTION | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | SUTTER HEALTH PLAN | $24K | $0 | $24K | 5.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 7.08% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | VISION SERVICE PLAN | $836 | $0 | $836 | 7.59% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC. | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $138 | $0 | $138 | 1.25% |
| MAROEVICH, O'SHEA AND COGHLAN INS.3 Filed as: MAROEVICH, OSHEA & COGHLAN | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | VISION SERVICE PLAN | -$128 | $0 | -$128 | -1.16% |
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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 104 | $1.5M |
| Dental(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $162K |
| Vision | VISION SERVICE PLAN | 148 | $11K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 104 | $1.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.