| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $60K | $0 | $60K | 5.60% |
| USI INSURANCE SERVICES LLC3 | 333 SOUTH GRAND AVENUE, SUITE 1450 LOS ANGELES, CA 90071 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $4K | $12K | 8.86% |
| ENROLLEASE3 | 660 YORK STREET, SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 2.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 970 RESERVE DRIVE ROSEVILLE, CA 95678 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $370 | $0 | $370 | 2.35% |
| ONE SOURCE ADVISORS INC3 Filed as: ONE SOURCE ADVISORS, LLC | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $350 | $0 | $350 | 2.23% |
| PAMELA KAY LONG3 | 200 SOUTH LEXINGTON DRIVE APARTMENT 615 FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $319 | $8 | $327 | 2.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $2 | $87 | 0.55% |
| DARRYL W VIDOR3 Filed as: DARRYL W. VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 0.52% |
| JOSEPHINE EBALO BACCAY3 | 3812 AETNA SPRINGS WAY SACRAMENTO, CA 95834 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.04% |
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 | 171 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 242 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 171 | $135K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 171 | $135K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 171 | $150K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 11 | $16K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 242 | $1.1M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 171 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.