| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS, INC. | 220 SOUTH RIDGEWOOD AVENUE DAYTONA BEACH, FL 32114 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | $0 | $13K | 2.69% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS, INC. | 2290 LUCIEN WAY, SUITE 400 MAITLAND, FL 32751 | CIGNA HEALTH AND LIFE INSURANCE COMAPNY AND AFFILIATES | $14K | $1K | $15K | 10.68% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS. INC. | 2290 LUCIEN WAY, SUITE 400 MAITLAND, FL 32751 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 9.46% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS, LLC | 1 BEACON STREET, SUITE 17100 BOSTON, MA 02108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 4.55% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS, INC. | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $200 | $0 | $200 | 1.12% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS, INC. | PO BOX 745921 ATLANTA, GA 30374 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | $989 | — | $989 | 8.09% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS, LLC | PO BOX 746600 ATLANTA, GA 30374 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | $989 | — | $989 | 8.09% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SLTNS, LLC | 1 BEACON STREET, SUITE 17100 BOSTOR, MA 02108 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | $981 | — | $981 | 8.03% |
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 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 67 | $501K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMAPNY AND AFFILIATES | 130 | $137K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | 186 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $124K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $124K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $124K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 67 | $501K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.