| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $50K | $0 | $50K | 4.92% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 10.00% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | SUTTER HEALTH PLAN | $6K | $0 | $6K | 5.00% |
| 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 | $347 | $0 | $347 | 4.74% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $333 | $0 | $333 | 4.55% |
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 | 126 | 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. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 88 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $135K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 160 | $7K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $135K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $135K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 88 | $1.1M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.