| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | KAISER PERMANENTE | $47K | — | $47K | 2.75% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | HEALTH NET | $10K | $31 | $10K | 4.47% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $563 | $3K | 17.92% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | $751 | — | $751 | 7.48% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 14.11% |
| BENEFITS TECHNOLOGIES LLC3 Filed as: BENEFITS TECHNOLOGIES | 1365 W. VISTA WAY VISTA, CA 92083 | AMERICAN FIDELITY ASSURANCE COMPANY | $85 | — | $85 | 1.04% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $772 | $198 | $970 | 16.13% |
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 | 221 | 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) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER PERMANENTE | 261 | $1.9M |
| Dental | HEALTH NET | 7 | $225K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 63 | $235K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 221 | $6K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 35 | $8K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 221 | $17K |
| Prescription drug(2 contracts, 2 carriers) | KAISER PERMANENTE | 261 | $1.9M |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 221 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.