| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASSIDY O'HARA3 | — | CINGA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $10K | — | $10K | 0.41% |
| CASSIDY O'HARA3 | — | CINGA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 0.19% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SERVICES OF CALIFORNIA | — | CINGA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$494 | — | -$494 | -0.02% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SERVICES OF CALIFORNIA | — | CINGA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$1K | — | -$1K | -0.05% |
| RELATION INSURANCE INC3 Filed as: RELATION INS SERVICES OF CALIFORNIA | 1277 TREAT BLVD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 2.04% |
| CASSIDY O'HARA3 | — | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 0.41% |
| CASSIDY O'HARA3 Filed as: CASSIDY EVAN O'HARA | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $599 | $5K | 8.51% |
| CASSIDY O'HARA3 Filed as: CASSIDY EVAN O'HARA | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 12.91% |
| CASSIDY O'HARA3 | — | VISION SERVICE PLAN | $1K | — | $1K | 4.24% |
| CASSIDY O'HARA3 Filed as: CASSIDY EVAN O'HARA | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $348 | $348 | 1.11% |
| CASSIDY O'HARA3 Filed as: CASSIDY EVAN O'HARA | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $253 | $3K | 16.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RON FILICE ENTERPRISES BROKER | Insurance agents and brokers Service code 22 | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | $108K |
| DIRECT DENTAL ADMINISTRATORS, LLC EIN 94-3270798 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $35K |
| CINGA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATOR | Non-monetary compensation; Claims processing; Other services; Float revenue; Named fiduciary; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $1K |
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 | 335 | 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) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CINGA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 508 | $3.0M |
| Vision | VISION SERVICE PLAN | 272 | $34K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $47K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $54K |
| Prescription drug(2 contracts, 2 carriers) | CINGA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 508 | $3.0M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.