| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $2K | $2K | 0.11% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $148K | $0 | $148K | 9.73% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | $0 | $19K | 8.65% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $7K | $0 | $7K | 3.35% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF CONSULTING, INC. | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $13 | $0 | $13 | 0.01% |
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 609 SAN FRANCISCO, CA 94111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 15.00% |
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 | 2,665 | 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) | 2,665 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 186 | $1.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 5,787 | $2.7M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 6,264 | $217K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,665 | $1.5M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,665 | $1.5M |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,665 | $1.5M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 186 | $1.9M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,665 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,264 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.