| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BOULEVARD SUITE 300 BURLINGAME, CA 94010 | KAISER FOUNDATION HEALTH PLAN, INC. | $50K | $1 | $50K | 4.47% |
| RSC INSURANCE BROKERAGE INC3 | — | QBE INSURANCE CORPORATION | $47K | — | $47K | 10.37% |
| RSC INSURANCE BROKERAGE INC3 | — | DELTA DENTAL OF CALIFORNIA | $10K | — | $10K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 10.00% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 6.48% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $32 | $32 | 0.05% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5 | $5 | 0.01% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.02% |
| RSC INSURANCE BROKERAGE INC3 | 1400 ROCKY RIDGE DRIVE SUITE 280 ROSEVILLE, CA 95661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 21.19% |
| RSC INSURANCE BROKERAGE INC3 | 1400 ROCKY RIDGE DRIVE SUITE 280 ROSEVILLE, CA 95661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 21.63% |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 161 | $1.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 139 | $195K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 331 | $15K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 177 | $68K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 177 | $68K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 177 | $68K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 161 | $1.1M |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 69 | $456K |
| Other(4 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 177 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 331 | — |
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.