| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC. | $53K | $0 | $53K | 4.98% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 5.86% |
| PORTAL INSURANCE AGENCY, INC.3 Filed as: PORTAL INSURANCE AGENCY INC | 2815 MITCHELL DRIVE, SUITE 205 WALNUT CREEK, CA 94598 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $417 | $0 | $417 | 5.87% |
| PORTAL INSURANCE AGENCY, INC.3 Filed as: PORTAL INSURANCE AGENCY INC | 80 SOUTH LAKE AVENUE, SUITE 600 PASADENA, CA 91101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $246 | $0 | $246 | 3.46% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 191 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $140K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 189 | $7K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $140K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $140K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 191 | $1.1M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 242 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.