| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $92K | — | $92K | 5.00% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 2.33% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2300 CONTRA COSTA BLVD SUITE 375 PLEASANT HILL, CA 94523 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.78% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 2.33% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2300 CONTRA COSTA BLVD STE 375 PLEASANT HILL, CA 94523 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.78% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $16K | — | $16K | 9.93% |
| BENEFITMALL3 | 2111 EAST HIGHLAND AVE SUITE B210 PHOENIX, AZ 85016 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $6K | $6K | 3.97% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 11.53% |
| BENEFITMALL3 | P.O. BOX 29675 DEPT 2027 PHOENIX, AZ 85038 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 3.63% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| BENEFITMALL3 | P.O. BOX 29675 DEPT 2027 PHOENIX, AZ 85038 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $5K | $5K | 7.13% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | VISION SERVICE PLAN | $3K | — | $3K | 10.06% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 100.00% |
| BENEFITMALL3 | P. O. BOX 29675 DEP 2027 PHOENIX, AZ 85038 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $947 | $947 | 7.42% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $485 | — | $485 | 10.00% |
| BENEFITMALL3 | 2111 EAST HIGHLAND AVE SUITE B210 PHOENIX, AZ 85016 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $0 | $194 | $194 | 4.00% |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | CIGNA DENTAL HEALTH OF COLORADO | $31 | — | $31 | 9.90% |
| BENEFITMALL3 | 2111 EAST HIGHLAND AVE SUITE B210 PHOENIX, AZ 85016 | CIGNA DENTAL HEALTH OF COLORADO | $0 | $13 | $13 | 4.15% |
| ROBERT M NISSIM4 Filed as: ROBERT M. NISSIM | 1038 BANCROFT RD CONCORD, CA 94518 | PREPAID LEGAL SERVICES INC DBA LEGALSHIELD | $813 | — | $813 | — |
| RIS EMPLOYEE BENEFITS INC3 | 221 MAIN STREET SUITE 1462 LOS ALTOS, CA 94023 | PREPAID LEGAL SERVICES INC DBA LEGALSHIELD | $401 | — | $401 | — |
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 | 207 | 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) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 242 | $2.4M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 163 | $166K |
| Vision | VISION SERVICE PLAN | 158 | $26K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 207 | $85K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 207 | $77K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 207 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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.