| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PIASC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 LOS ANGELES, CA 90040 | KAISER FOUNDATION HEALTH PLAN, INC. | $675K | — | $675K | 6.95% |
| PAI-SC INSURANCE SERVICES, INC.3 | 5800 S EASTERN AVE STE 400 COMMERCE, CA 900404021 | KAISER FOUNDATION HEALTH PLAN INC. | $240K | — | $240K | 6.97% |
| PIA-SC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 LOS ANGELES, CA 90040 | HEALTHNET | $0 | — | $0 | 0.00% |
| PIA-SC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 COMMERCE, CA 90040 | ARMADA CARE | $5K | — | $5K | 1.43% |
| PIA-SC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 LOS ANGELES, CA 90040 | HEALTHNET | $0 | — | $0 | 0.00% |
| PIASC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 COMMERCE, CA 900404016 | VISION SERVICE PLAN | $0 | — | $0 | 0.00% |
| PIASC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE COMMERCE, CA 90040 | HUMANA DENTAL INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| PIA-SC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 COMMERCE, CA 90040 | WESTERN DENTAL SERVICES, INC. | $3K | — | $3K | 10.39% |
| PIASC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 LOS ANGELES, CA 90040 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $71 | — | $71 | 0.52% |
| PIASC INSURANCE SERVICES, INC.3 | 5800 S. EASTERN AVENUE, SUITE 400 LOS ANGELES, CA 900404021 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PIA-SC INSURANCE SERVICES EIN 95-3988532 AFFILIATE | Other fees; Plan Administrator Service code 14 | — | $2.1M |
| GROUP & PENSION ADMINISTRATOR (GPA) EIN 04-1868050 NONE | Plan Administrator Service code 14 | — | $1.1M |
| PAYER MATRIX, LLC EIN 81-3946362 AFFILIATE | Claims processing Service code 12 | — | $408K |
| PIASC-INSURACE SERVICES EIN 95-3988532 AFFILIATE | Insurance services Service code 23 | — | $157K |
| ITS PASADENA, LLC EIN 81-4403537 NONE | Other fees Service code 99 | — | $62K |
| WINDES EIN 95-3001179 NONE | Accounting (including auditing) Service code 10 | — | $54K |
| PIASC EIN 95-1501502 AFFILIATE | Other fees Service code 99 | — | $52K |
| OLIVER WYMAN, INC. EIN 52-1066481 NONE | Actuarial Service code 11 | — | $46K |
| CALIFORNIA ASSO. OF SMALL EMPLOYER EIN 33-0835612 NONE | Other fees Service code 99 | — | $36K |
| PIA-SC EIN 95-1501502 AFFILIATE | Participant communication; Other fees Service code 38 | — | $31K |
| CLIFFORD SWAN INVESTMENT COUNSEL LL EIN 95-4749812 NONE | Investment management fees paid directly by plan Service code 51 | — | $26K |
| IRON MOUNTAIN EIN 04-3038590 NONE | Other fees Service code 99 | — | $24K |
| MARINA GRAPHICS, INC. EIN 95-2922372 NONE | Copying and duplicating Service code 36 | — | $22K |
| ATKINSON, ANDELSON, LOYA, RUUD & RO EIN 95-3378600 NONE | Legal Service code 29 | — | $21K |
| THE CASTLE PRESS EIN 95-3476370 NONE | Copying and duplicating Service code 36 | — | $20K |
| AMERICAN EXPRESS EIN 13-3133497 NONE | Other fees Service code 99 | — | $15K |
| DIRECT CONNECTION EIN 33-0659758 NONE | Copying and duplicating Service code 36 | — | $12K |
| DOCTOR LAW GROUP LLP EIN 46-1696808 NONE | Legal Service code 29 | — | $10K |
| FOR2FI, INC EIN 85-3863675 NONE | Other fees Service code 99 | — | $7K |
| PRINT.N.COPY EIN 90-0242560 NONE | Copying and duplicating Service code 36 | — | $6K |
| CANNON FINANCIAL EIN 22-3056822 NONE | Other fees Service code 99 | — | $6K |
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 | 4,212 | 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) | 4,212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(34 contracts, 7 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,178 | $28.5M |
| Dental(6 contracts, 4 carriers) | HUMANA INSURANCE COMPANY | 852 | $1.4M |
| Vision(4 contracts, 2 carriers) | VISION SERVICE PLAN | 3,083 | $194K |
| Other(2 contracts, 2 carriers) | TELLES HEALTH | 664 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,083 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.