| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3631 S. HARBOR BLVD., SUITE 200 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $108K | — | $108K | 0.76% |
| LBL INSURANCE SERVICES INC3 | 3631 S HARBOR BLVD STE 200 SUITE 200 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $80K | — | $80K | 0.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 203383 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $94K | — | $94K | 2.17% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LAKESPUR LANDING CIRCLE STE 116 ARKSPUR, CA 94939 | STANDARD INSURANCE COMPANY | $40K | — | $40K | 0.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | 335 MADISON AVE FLOOR 20 NEW YORK, NY 100174633 | RELIASTAR INSURANCE COMPANY | — | $72K | $72K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3631 S HARBOR BLVD SUITE 200 SANTA ANA, CA 92704 | AETNA INTERNATIONAL | $187 | — | $187 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $930K |
| PAYFLEX TPA | Contract Administrator; Account maintenance fees Service code 13 | 10802 FARNAM DRIVE SUITE 100 OMAHA, NE 68154 | $74K |
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 | 5,012 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 39 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,080 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 3,618 | $26.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 2,461 | $378K |
| Vision | VISION SERVICE PLAN | 3,222 | $543K |
| Life insurance | STANDARD INSURANCE COMPANY | 4,409 | $4.3M |
| Short-term disability | STANDARD INSURANCE COMPANY | 4,409 | $4.3M |
| Long-term disability | STANDARD INSURANCE COMPANY | 4,409 | $4.3M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 3,618 | $14.2M |
| Stop-loss / reinsurancereinsurance | RELIASTAR INSURANCE COMPANY | 2,823 | $1.4M |
| Other(2 contracts, 2 carriers) | HEALTH AND HUMAN RESOURCES CENTER, INC. | 5,012 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,012 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.