| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC. | $870 | — | $870 | 0.44% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 2.06% |
| AIT SERVICES LLC3 Filed as: AIT SERVICES LLCS DBA APPRIZE PARTN | 840 LAKE STREET E 2A WAYZATA, MN 55391 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $341 | — | $341 | 0.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEKETA FIDUCIARY MGMT LLC OUTSOURCED CIO | Investment advisory (plan) Service code 27 | 5796 ARMAD DRIVE, SUITE 110 CARLSBAD, CA 92008 | $25K |
| HOLTHOUSE CARLIN & VAN TRIGHT LLP EIN 95-4345526 AUDITOR | Accounting (including auditing) Service code 10 | — | $16K |
| US BANK NATIONAL ASSOCIATION CUSTODIAN | Custodial (securities) Service code 19 | 800 NICOLLET MALL MINNEAPOLIS, MN 55402 | $9K |
| GRANT THORNTON LLP EIN 36-6055558 ADVISOR | Accounting (including auditing); Investment advisory (plan) Service code 10 | — | $8K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 96 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 72 | $199K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 96 | $74K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 72 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 96 | — |
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."
No prospect flags tripped on this filing.