| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | $1 | $22K | 3.61% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 5.70% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 2.79% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | ONE VENTURE, SUITE 220 IRVINE, CA 92618 | GUARDIAN | $3K | — | $3K | 9.64% |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 107 | $599K |
| Dental | GUARDIAN | 159 | $29K |
| Life insurance | GUARDIAN | 159 | $29K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 36 | $73K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 36 | $73K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 107 | $599K |
| Other(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 159 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.