| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | BLUE CROSS OF CALIFORNIA | $261K | — | $261K | 2.56% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | KAISER FOUNDATION HEALTH PLAN INC | $82K | — | $82K | 2.73% |
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 | 1,150 | 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) | 1,150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 2,268 | $13.2M |
| Dental | BLUE CROSS OF CALIFORNIA | 2,268 | $10.2M |
| Vision | BLUE CROSS OF CALIFORNIA | 2,268 | $10.2M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 2,268 | $10.2M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 2,268 | $10.2M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 2,268 | $10.2M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 2,268 | $13.2M |
| Other | BLUE CROSS OF CALIFORNIA | 2,268 | $10.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,268 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.