| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS OR INC | 1800 SOUTHWEST 1ST AVENUE STE 400 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | — | $12K | $12K | 0.19% |
| JOHN A. LUDDEKE3 Filed as: JOHN DAVID FALCON | — | BLUE CROSS BLUE SHIELD OF TEXAS | $177K | $2K | $180K | 5.85% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES NY LLC | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $22K | — | $22K | 1.58% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN P FORAN INS AGCY INC | — | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | $11K | $583 | $12K | 0.84% |
| JOHN A. LUDDEKE3 Filed as: JOHN DAVID FALCON | — | BLUE CROSS BLUE SHIELD OF TEXAS | $65K | $2K | $67K | 5.94% |
| NATIONAL INSURANCE CONSULTANTS INC.3 | 8687 W SAHARA AVENUE LAS VEGAS, NV 89117 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 5.00% |
| MARK WALSH3 | 2125 EDINBORO AVENUE CLAIRMONT, CA 91711 | CALIFORNIA DENTAL NETWORK, INC. | $291 | — | $291 | 5.01% |
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 | 7,135 | 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) | 7,135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(11 contracts, 9 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,395 | $24.5M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS | 1,095 | $1.7M |
| Vision | VISION SERVICE PLAN | 4,577 | $383K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 9,558 | $1.6M |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 9,558 | $1.6M |
| Long-term disability | STANDARD INSURANCE COMPANY | 9,558 | $1.1M |
| Prescription drug(10 contracts, 8 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,395 | $23.1M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,349 | $560K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,558 | — |
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.