| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 10877 WHITE ROCK ROAD, SUITE 300 RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC. | $57K | — | $57K | 3.97% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 10877 WHITE ROCK ROAD, SUITE 300 RANCHO CORDOVA, CA 95670 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 11.79% |
| SELERIX INSURANCE SERVICES, LLC3 Filed as: SELERIX INSURANCE SERVICES LLC | 2851 CRAIG DR, STE 300 MCKINNEY, TX 75072 | TRANSAMERICA LIFE INSURANCE COMPANY | $250 | — | $250 | 5.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 100 SUNNYSIDE ROAD WOODBURY, NY 11797 | TRANSAMERICA LIFE INSURANCE COMPANY | $249 | — | $249 | 5.10% |
| 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 | $104 | — | $104 | 2.13% |
| FNA INS SERVICES INC3 | 1000 WOODBURY RD, STE 403 WOODBURY, NY 11797 | TRANSAMERICA LIFE INSURANCE COMPANY | $21 | — | $21 | 0.43% |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 208 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $111K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $111K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $111K |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 23 | $5K |
| Long-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 23 | $5K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 208 | $1.4M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.