| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL | SERVICES INC 777 MARINERS ISLAND BLVD, STE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 1.50% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 1.02% |
| ROGERS BENEFIT GROUP INC3 | 8000 NORMAN CENTER DR STE 605 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 2.71% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 3155 OLSEN DR SAN JOSE, CA 95117 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $334 | $2K | 2.27% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SERVICES | INC 777 MARINERS ISLAND BLVD, STE 250 SAN MATEO, CA 94404 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.52% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 8000 NORMAN CENTER DR STE 605 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.99% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVCS INC | DBA ABD INSURANCE 777 MARINERS ISLAND BLVD, STE 250 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | — | $924 | $924 | 0.90% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL | 777 MARINERS ISLAND BLVD STE 250 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $701 | $123 | $824 | 7.06% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST I | 3155 OLSEN DRIVE SUITE 400 SAN JOSE, CA 95117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $582 | $116 | $698 | 5.98% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES, LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $440 | — | $440 | 4.10% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL SERVICE | 777 MARINERS ISLAND BLVD STE 250 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $354 | — | $354 | 3.30% |
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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 89 | $773K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 180 | $102K |
| Vision | VISION SERVICE PLAN | 83 | $11K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 115 | $12K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 115 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.