| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $138K | $4K | $141K | 2.10% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $30K | — | $30K | 0.45% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC. | $81K | — | $81K | 1.92% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | HARTFORD LIFE AND ACCIDENT | $4K | $7K | $11K | 7.44% |
| VARIOUS - SEE ATTACHED3 | C/O CONTINENTAL AMERICAN INS CO PO BOX 427 COLUMBUS, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17K | — | $17K | 12.63% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $2K | — | $2K | 2.50% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC. | $852 | — | $852 | 1.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HOLTHOUSE CARLIN & VAN TRIGHT LLP EIN 95-4345526 AUDITOR | Accounting (including auditing) Service code 10 | — | $27K |
| MEKETA FIDUCIARY MGMT LLC OUTSOURCED CIO | Investment advisory (plan) Service code 27 | 5796 ARMAD DRIVE, SUITE 110 CARLSBAD, CA 92008 | $25K |
| US BANK NATIONAL ASSOCIATION CUSTODIAN | Custodial (securities) Service code 19 | 800 NICOLLET MALL MINNEAPOLIS, MN 55402 | $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 | 825 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 87 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 912 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 880 | $11.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 880 | $6.7M |
| Vision(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 800 | $4.4M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 782 | $142K |
| Prescription drug(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 880 | $11.0M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 860 | $300K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 880 | — |
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.