| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $56K | — | $56K | 3.00% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | UNITED HEALTHCARE INSURANCE COMPANY | $45K | — | $45K | 3.58% |
| WELLS FARGO INSURANCE SERVICES3 | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | DELTA DENTAL OF CALIFORNIA | $19K | — | $19K | 5.01% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.86% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 30001 TAMPA, FL 33601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 3.46% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | VISION SERVICE PLAN | $2K | — | $2K | 4.32% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $481 | — | $481 | 2.70% |
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 | 336 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 325 | $3.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 541 | $374K |
| Vision | VISION SERVICE PLAN | 334 | $36K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 286 | $61K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 286 | $61K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 286 | $61K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 325 | $3.1M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 349 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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.