| 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 | $43K | — | $43K | 2.82% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | SUN LIFE ASSURANCE COMPANY OF CANADA | $46K | — | $46K | 7.56% |
| MGIS5 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $180 | $180 | 0.03% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | VISION SERVICE PLAN | $5K | — | $5K | 2.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $768K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $99K |
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 | 1,077 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,084 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 227 | $1.5M |
| Vision | VISION SERVICE PLAN | 1,064 | $171K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,174 | $610K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,174 | $610K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 227 | $1.5M |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORPORATION | 866 | $1.1M |
| Other | MANAGED HEALTH NETWORK | 1,174 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,174 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.