| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | KAISER FOUNDATION HEALTH PLANS, INC. | $87K | — | $87K | 1.48% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP, DBA JENKINS INS GRP | 1390 WILLOW PASS RD CONCORD, CA 94520 | KAISER FOUNDATION HEALTH PLANS, INC. | -$85 | — | -$85 | -0.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94620 | AETNA LIFE INSURANCE COMPANY | $16K | $5K | $22K | 2.24% |
| JAMES C JENKINS INSURANCE SERVICE3 Filed as: JAMES C. JENKINS, INS. SVCS., INC. | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $5K | — | $5K | 0.48% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 123 MISSION ST 26TH FL SAN FRANCISCO, CA 94105 | WESTERN HEALTH ADVANTAGE | $20K | — | $20K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED ADMINISTRATIVE SERVICES EIN 94-1749354 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $168K |
| NEYHART, ANDERSON, FLYNN & GROSBOLL EIN 94-2576729 NONE | Legal; Direct payment from the plan Service code 29 | — | $65K |
| KAUFMANN AND GOBLE ASSOCIATES, INC. EIN 94-2614826 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $38K |
| GARCIA HAMILTON & ASSOCIATES, LP EIN 76-0589652 NONE | Direct payment from the plan; Investment management fees paid directly by plan Service code 50 | — | $36K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 26-4310632 NONE | Direct payment from the plan; Investment management fees paid directly by plan Service code 50 | — | $20K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
| COMPLIANCE AUDIT SERVICES NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 719 ADAM ST MOUNTAIN HOUSE, CA 95391 | $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 | 811 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 811 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLANS, INC. | 1,456 | $7.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,422 | $1.2M |
| Vision | VISION SERVICE PLAN | 828 | $87K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 155 | $979K |
| Other | MANAGED HEALTH NETWORK | 813 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,422 | — |
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.