| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH 12 FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $68K | $0 | $68K | 2.95% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 201 MISSION STREET, FLOOR 11 SAN FRANCISCO, CA 94105 | UNITEDHEALTHCARE INSURANCE COMPANY | $53K | $0 | $53K | 3.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 959 SKYWAY ROAD 2ND FLOOR SAN CARLOS, CA 94070 | DELTA DENTAL OF CALIFORNIA | $18K | $0 | $18K | 3.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD 2ND FLOOR SAN CARLOS, CA 94070 | DELTA DENTAL OF CALIFORNIA | $6K | $0 | $6K | 1.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 201 MISSION STREET SAN FRANCISCO, CA 94105 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 8.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 301 EAST PINE STREET SUITE 240 ORLANDO, FL 32801 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $0 | $1K | 3.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 45 FREEMONT STREET SUITE 800 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $241 | $0 | $241 | 2.21% |
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 | 359 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 347 | $3.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 624 | $472K |
| Vision | VISION SERVICE PLAN | 349 | $104K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 343 | $90K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 343 | $90K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 343 | $90K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 347 | $3.9M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,615 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,615 | — |
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.