| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | KAISER FOUNDATION HEALTH PLAN, INC. | $36K | — | $36K | 2.65% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 W OFFICE CENTER DR, SUITE 215 FORT WASHINGTON, PA 19034 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 4.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $60 | $60 | 0.01% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 107 SAN JOSE, CA 95103 | VISION SERVICE PLAN | $2K | — | $2K | 2.76% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 107 SAN JOSE, CA 95103 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | — | $1K | 3.77% |
| GIS BENEFITS INC3 Filed as: GIS NORTHERN CALIFORNIA | 315 MONTGOMERY ST, SUITE 900 SAN FRANCISCO, CA 94104 | METLIFE LEGAL PLANS | $2K | — | $2K | 11.03% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 2 NORTH MARKET STREET SUITE 600 SAN JOSE, CA 95113 | METLIFE LEGAL PLANS | $2K | — | $2K | 10.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, BLDG 1 SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $987 | $987 | 5.13% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 95 S MARKET ST, STE 600 SAN JOSE, CA 95113 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 27.32% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 95 S MARKET ST, STE 600 SAN JOSE, CA 95113 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 29.27% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 95 S MARKET ST, STE 600 SAN JOSE, CA 95113 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 24.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $665 | — | $665 | 10.00% |
| INNOVATIVE COST MANAGEMENT SERVICES3 | 95 S MARKET ST, STE 600 SAN JOSE, CA 95113 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 39.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | FEDERAL INSURANCE COMPANY | $656 | $61 | $717 | 16.39% |
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 | 338 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 136 | $1.4M |
| Vision | VISION SERVICE PLAN | 320 | $87K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 329 | $446K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 329 | $446K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 329 | $446K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 136 | $1.4M |
| Other(9 contracts, 6 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 850 | $542K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 850 | — |
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."
No prospect flags tripped on this filing.