| 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 | $55K | $0 | $55K | 3.23% |
| ACE BENEFIT PARTNERS, INC.3 Filed as: ACE BENEFIT PARTNERS INC | 1990 N CALIFORNIA BLVD STE 900 WALNUT CREEK, CA 945963776 | RELIASTAR LIFE INSURANCE COMPANY | $13K | $55K | $68K | 6.20% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $730 | $9K | 0.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $41 | $41 | 0.00% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $39K | $0 | $39K | 7.54% |
| MGIS5 | 10 WEST BROADWAY STE 800 SALT LAKE CITY, UT 84101 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $180 | $180 | 0.03% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.16% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $5K | $37 | $5K | 10.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $568K |
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 | 1,146 | 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) | 1,147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 243 | $1.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,112 | $964K |
| Vision | VISION SERVICE PLAN | 1,124 | $160K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,063 | $517K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,063 | $517K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 243 | $1.7M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 817 | $1.1M |
| Other | MANAGED HEALTH NETWORK | 500 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,112 | — |
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.