| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOLD SKY BENEFITS LLC3 | 21425 42ND AVENUE BAYSIDE, NY 11361 | KAISER FOUNDATION HEALTH PLAN INC. | $50K | — | $50K | 3.24% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 10877 WHITE ROCK ROAD, SUITE 300 RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 0.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 801 S. FIGUEROA STREET, SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 0.55% |
| BXA INSURANCE SERVICES3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $33 | — | $33 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 214-25 42ND AVE, 3RD FL BAYSIDE, NY 11361 | GUARDIAN | $11K | $3K | $14K | 11.92% |
| MARK J MATSOCK & ASSOCIATES INC3 Filed as: MARK S MTTTILLE | 107 CANDLELIGHT LANE MORRIS, IL 60450 | GUARDIAN | $5K | — | $5K | 3.91% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 10877 WHITE ROCK ROAD, SUITE 300 RANCHO CORDOVA, CA 95670 | GUARDIAN | $2K | — | $2K | 2.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 100 SUNNYSIDE ROAD WOODBURY, NY 11797 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 21.89% |
| TBX EMPLOYEE BENEFITS LLC3 Filed as: TBX EMPLOYEE BENEFITS, LLC | 1201 ELM STREET, SUITE 4250 DALLAS, TX 75270 | TRANSAMERICA LIFE INSURANCE COMPANY | $326 | — | $326 | 5.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 525 MARKET STREET, SUITE 3400 SAN FRANCISCO, CA 94105 | TRANSAMERICA LIFE INSURANCE COMPANY | $169 | — | $169 | 2.90% |
| FNA INS SERVICES INC3 | 1000 WOODBURY RD, STE 403 WOODBURY, NY 11797 | TRANSAMERICA LIFE INSURANCE COMPANY | $163 | — | $163 | 2.79% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $227 | — | $227 | 10.36% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $39 | — | $39 | 10.43% |
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 | 253 | 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) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 242 | $1.5M |
| Dental | GUARDIAN | 253 | $119K |
| Vision | GUARDIAN | 253 | $119K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 253 | $122K |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 44 | $6K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 242 | $1.5M |
| Other(3 contracts, 3 carriers) | GUARDIAN | 253 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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.
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.