| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| A.G. SIEBEN & ASSOCIATES3 | 800 AIRPORT BLVD. #318 BURLINGAME, CA 94010 | METLIFE | $758K | $400K | $1.2M | 2.28% |
| A.G. SIEBEN & ASSOCIATES3 | 800 AIRPORT BLVD #318 BURLINGAME, CA 94010 | HARTFORD LIFE & ACCIDENT | $225K | $185K | $410K | 1.82% |
| A.G. SIEBEN & ASSOCIATES3 | 800 AIRPORT BLVD #318 BURLINGAME, CA 94010 | RELIASTAR | $202K | $0 | $202K | 2.00% |
| A.G. SIEBEN & ASSOCIATES3 | 800 AIRPORT BLVD. #318 BURLINGAME, CA 94010 | CIGNA | $36K | — | $36K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UHC EIN 36-2739571 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | — | $20.4M |
| METLIFE EIN 13-5581829 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | — | $1.4M |
| VSP CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | — | $588K |
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 | 45,491 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 879 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 46,375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | KAISER - CALIFORNIA | 6,652 | $57.9M |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE & ACCIDENT | 45,491 | $22.5M |
| Long-term disability | HARTFORD LIFE & ACCIDENT | 45,491 | $22.5M |
| Prescription drug(6 contracts, 6 carriers) | KAISER - CALIFORNIA | 6,652 | $57.9M |
| Stop-loss / reinsurancereinsurance | RELIASTAR | 38,657 | $10.1M |
| Other(2 contracts, 2 carriers) | METLIFE | 45,491 | $50.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 45,491 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.