| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | TWO EMBARCADERO CENTER SUITE 1700 SAN FRANCISCO, CA 94111 | AETNA HEALTH, INC. | $34K | — | $34K | 2.31% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | AETNA HEALTH, INC. | $18K | — | $18K | 1.21% |
| LOCKTON COMPANIES, LLC3 | TWO EMBARCADERO CENTER SUITE 1700 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $20K | — | $20K | 2.19% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 0.69% |
| LOCKTON COMPANIES, LLC3 | TWO EMBARCADERO CENTER SUITE 1700 SAN FRANCISCO, CA 94111 | AETNA LIFE INSURANCE COMPANY | $14K | — | $14K | 2.37% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | AETNA LIFE INSURANCE COMPANY | $6K | — | $6K | 1.04% |
| LOCKTON COMPANIES, LLC3 | 717 NORTH HARWOOD STREET DALLAS, TX 75201 | AETNA LIFE INSURANCE COMPANY | — | $253 | $253 | 0.04% |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 160 | $3.0M |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 295 | $85K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 264 | $131K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 160 | $3.0M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 295 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.