| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 900 NORTH SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | WESTERN HEALTH ADVANTAGE | $28K | — | $28K | 3.72% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 2.73% |
| VITA INSURANCE ASSOCIATES, INC.3 | — | NATIONAL GUARDIAN LIFE INSURANCE | $2K | — | $2K | 2.43% |
| VITA INSURANCE ASSOCIATES, INC.3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 16.50% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 120 | $878K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $54K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE | 181 | $69K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $54K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $54K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 120 | $878K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.