| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BOULEVARD PH SUITE IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $35K | — | $35K | 3.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 0.67% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | HEALTH NET | $14K | — | $14K | 3.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | HEALTH NET | $2K | — | $2K | 0.47% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 7.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3716 NORFOLK, VA 23510 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.79% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 245 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $184K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $184K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $184K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 245 | $1.5M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 146 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.