| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE SUITE 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | $0 | $20K | 1.70% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | $21 | $14K | 1.22% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE SUITE 100 MENLO PARK, CA 94025 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $3K | $9K | 17.12% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING SUITE 180 LARKSPUR, CA 94939 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 7.63% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE SUITE 100 MENLO PARK, CA 94025 | VISION SERVICE PLAN | $575 | $0 | $575 | 5.16% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 LARKSPUR, CA 94939 | VISION SERVICE PLAN | $215 | $0 | $215 | 1.93% |
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 | 179 | 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) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 179 | $1.2M |
| Vision | VISION SERVICE PLAN | 126 | $11K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $55K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $55K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 179 | $1.2M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.