| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | $38K | $13K | $51K | 8.27% |
| MARSH & MCLENNAN AGENCY LLC3 | 100 FRONT ST STE 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $24K | $3K | $27K | 4.34% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2000 ALAMEDA DE LAS PULGAS STE 101 SAN MATEO, CA 94403 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2000 ALAMEDA DE LAS PULGAS STE 101 SAN MATEO, CA 94403 | CONCERN EAP | $301 | — | $301 | 2.56% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWN CENTRE DRIVE, SUITE 100 SAN DIEGO, CA 92122 | CONCERN EAP | $286 | — | $286 | 2.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE N/A | Contract Administrator; Direct payment from the plan Service code 13 | 9700 HEALTH CARE LANE MINNETONKA, MN 55343 | $404K |
| EDGEWOOD PARTNERS INSURANCE CEN N/A | Other commissions; Direct payment from the plan Service code 50 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | $62K |
| INTERREMEDY INSURANCE SERVICES N/A | Direct payment from the plan; Contract Administrator Service code 13 | 315 MONTGOMERY STREET SUITE 900 SAN FRANCISCO, CA 94104 | $60K |
| DELTA DENTAL N/A | Direct payment from the plan; Contract Administrator Service code 13 | 100 FIRST STREET SAN FRANCISCO, CA 94105 | $53K |
| MOSS ADAMS LLP EIN 91-0189318 N/A | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $45K |
| VISION SERVICE PLAN EIN 94-1632821 N/A | Direct payment from the plan; Contract Administrator Service code 13 | — | $28K |
| BUSINESS SOLVER N/A | Direct payment from the plan; Contract Administrator Service code 13 | 1025 ASHWORTH ROAD WEST DES MOINES, IA 50265 | $28K |
| THE LARKIN COMPANY N/A | Direct payment from the plan; Contract Administrator Service code 13 | 2350 MISSION COLLEGE BLVD, SUITE 39 SANTA CLARA, CA 95054 | $13K |
| TRUCKER HUSS N/A | Legal; Direct payment from the plan Service code 29 | 1 EMBARCADERO CENTER SAN FRANCISCO, CA 94111 | $10K |
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 | 178 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 252 | $2.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 653 | $620K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 653 | $620K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 252 | $2.0M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 711 | $661K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 711 | — |
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."
No prospect flags tripped on this filing.