| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC | $59K | $6 | $59K | 5.01% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | BLUE SHIELD OF CALIFORNIA; CALIFORNIA PHYSICIANS' SERVICE | $6K | — | $6K | 5.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $4K | $15K | 25.65% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $862 | — | $862 | 10.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD. MOUNTAIN VIEW, CA 94043 | CONCERN EAP | $344 | — | $344 | 5.00% |
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 | 108 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 190 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $57K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 55 | $9K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $57K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $57K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 190 | $1.3M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.