| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | CALIFORNIA PHYSICIANS' SERVICE | $169 | $141K | $141K | 3.68% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC. | $23K | — | $23K | 2.85% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B ST FL 6 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC. | — | $674 | $674 | 0.08% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 4.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.33% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $40 | $40 | 0.01% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 95 MARKET ST, STE 600 SAN JOSE, CA 95113 | VISION SERVICE PLAN | $2K | — | $2K | 2.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 317 NW GILMAN BLVD., SUITE 51 ISSAQUAH, WA 98027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 317 NW GILMAN BLVD., SUITE 51 ISSAQUAH, WA 98027 | FEDERAL INSURANCE COMPANY | $668 | $4 | $672 | 15.10% |
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 | 273 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 212 | $4.6M |
| Vision | VISION SERVICE PLAN | 265 | $79K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 273 | $418K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 212 | $4.6M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 275 | $438K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.