| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS DBA KLEINBERG BENEFITS INC INS | 10011 N FOOTHILL BLVD., STE 110 CUPERTINO, CA 95014 | KAISER FOUNDATION HEALTH PLANS, INC. | $31K | — | $31K | 5.40% |
| EAST WEST ADMINISTRATORS3 | 40485 ENCYCLOPEDIA CIRCLE FREMONT, CA 94538 | PAN-AMERICAN LIFE INSURANCE COMPANY | $39K | — | $39K | 15.00% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS DBA KLEINBERG BENEFITS INC INS | 10011 N. FOOTHILL BLVD., STE 110 CUPERTINO, CA 95014 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 5.42% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS INC DBA KBI | 10011 N FOOTHILL BLVD STE 110 CUPERTINO, CA 95014 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 12.00% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $51 | $51 | 0.06% |
| RIS EMPLOYEE BENEFITS INC3 | 10011 N. FOOTHILL BLVD., STE 110 CUPERTINO, CA 95014 | VISION SERVICE PLAN | $1K | — | $1K | 5.36% |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS, INC. | 110 | $826K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 309 | $124K |
| Vision | VISION SERVICE PLAN | 116 | $21K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 146 | $79K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 146 | $79K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 146 | $79K |
| Stop-loss / reinsurancereinsurance | PAN-AMERICAN LIFE INSURANCE COMPANY | 60 | $260K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 146 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.