| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN, INC. | $40K | $0 | $40K | 4.42% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | DELTA DENTAL OF CALIFORNIA | $5K | $0 | $5K | 9.20% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $144 | $3K | 14.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: A DICKERSON EMPLOYEE BENEFITS | 333 NORTH GLENOAKS BOULEVARD SUITE 410 BURBANK, CA 91502 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $273 | $273 | 1.42% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | PO BOX 736061 CHICAGO, IL 60673 | VISION SERVICE PLAN | $874 | — | $874 | 5.96% |
| DEWITT STERN OF CALIFORNIA LLC3 Filed as: DEWITT STERN OF CA INSURANCE | 500 NORTH BRAND BOULEVARD SUITE 1600 GLENDALE, CA 91203 | VISION SERVICE PLAN | $44 | — | $44 | 0.30% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC. | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | -$387 | — | -$387 | -2.64% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 118 | $900K |
| Dental | DELTA DENTAL OF CALIFORNIA | 138 | $57K |
| Vision | VISION SERVICE PLAN | 74 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $19K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 118 | $900K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.