| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC. | $37K | — | $37K | 2.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 2.38% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA BENEFITS GROUP | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 2.50% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INS ASSOC INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $4K | $8K | 14.40% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | CONCERN EAP | $989 | — | $989 | 5.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA BENEFITS GROUP | 900 N. SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | DELTA DENTAL OF CALIFORNIA | $363 | — | $363 | 2.50% |
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 | 341 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 250 | $2.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 275 | $205K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 341 | $56K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 341 | $56K |
| Short-term disability | STANDARD INSURANCE COMPANY | 30 | $29K |
| Long-term disability | STANDARD INSURANCE COMPANY | 30 | $29K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 250 | $2.1M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 466 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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.