| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MINDSHARE BENEFITS & INSURANCE SERV3 | 180 SPRING ST PLEASANTON, CA 94566 | KAISER FOUNDATION HEALTH PLAN, INC | $34K | $0 | $34K | 4.98% |
| BROWN AND BROWN OF FLORIDA, INC.0 Filed as: WORD & BROWN, INSURANCE ADMINISTRAT | 721 S PARKER ST STE 300 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN, INC | $10K | $0 | $10K | 1.42% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 180 SPRING ST PLEASANTON, CA 94566 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $0 | $6K | 5.00% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 127 SPRING ST STE 115 PLEASANTON, CA 94566 | UNITEDHEALTHCARE INSURANCE COMPANY | $34 | $0 | $34 | 0.03% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 180 SPRING ST PLEASANTON, CA 94566 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $642 | $9K | 9.34% |
| ENROLLEASE0 Filed as: ENROLLEASE INC | 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 89135 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.87% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 180 SPRING ST PLEASANTON, CA 94566 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 180 SPRING ST PLEASANTON, CA 94566 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.16% |
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 | 91 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 92 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 79 | $805K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 82 | $94K |
| Vision | VISION SERVICE PLAN | 82 | $23K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $25K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 79 | $805K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 91 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.