| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 1.01% |
| RICO PFITZER PIRES EMPLOYEE BENEFIT3 Filed as: RICO PFITZER PIRES EMP BENEFIT SVCS | PO BOX 129 GUSTINE, CA 95322 | KAISER FOUNDATION HEALTH PLAN INC | -$850 | $0 | -$850 | -0.07% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A EAST LASSEN AVENUE CHICO, CA 95973 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $2K | $18K | 10.65% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $134 | $4K | 2.49% |
| RICO PFITZER PIRES EMPLOYEE BENEFIT3 Filed as: RICO PFITZER PIRES EMP BENEFIT SVCS | 207 5TH STREET GUSTINE, CA 95322 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.03% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $2K | $0 | $2K | 2.91% |
| RICO PFITZER PIRES EMPLOYEE BENEFIT3 Filed as: RICO PFITZER PIRES EMP BENEFIT SVCS | PO BOX 129 GUSTINE, CA 95322 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $107 | $0 | $107 | 0.15% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 9.23% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $513 | $0 | $513 | 2.60% |
| RICO PFITZER PIRES EMPLOYEE BENEFIT3 Filed as: RICO PFITZER PIRES EMP BENEFIT SVCS | PO BOX 129 GUSTINE, CA 95322 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $29 | $0 | $29 | 0.15% |
| RICO PFITZER PIRES EMPLOYEE BENEFIT3 Filed as: RICO PFITZER PIRES EMP BENEFIT SVCS | 207 5TH STREET GUSTINE, CA 95322 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 26.21% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC | 1357 A EAST LASSEN AVENUE CHICO, CA 95973 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 15.96% |
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 | 401 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 172 | $1.4M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 259 | $30K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $179K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $172K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $172K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 172 | $1.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $172K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.