| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | BLUE CROSS OF CALIFORNIA | $9K | $0 | $9K | 5.00% |
| KERR, WELDON G3 | RBG SAN JOSE 6155 ALMADEN EXPY #210 SAN JOSE, CA 95120 | BLUE CROSS OF CALIFORNIA | $0 | $4K | $4K | 2.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 4.94% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 7.46% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610250 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $709 | $3K | 5.79% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.48% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610250 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $292 | $1K | 5.81% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.49% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610250 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $994 | $428 | $1K | 6.45% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $55 | $2K | 8.04% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 77056 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $238 | $238 | 1.27% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $637 | $0 | $637 | 7.77% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610250 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $346 | $291 | $637 | 7.77% |
| MASOLI LEGACY LLC4 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 25.68% |
| EDGEWOOD PARTNERS INSURANCE CENTER4 Filed as: EDGEWOOD PARTNERS INSURANCE CE | PO BOX 5668 CONCORD, CA 94524 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $92 | $0 | $92 | 2.29% |
| LEIA MUNIZ4 | 4012 MARRON ST SAN DIEGO, CA 92115 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $33 | $0 | $33 | 0.82% |
| MELITA-MCDONALD INSURANCE SERVICES4 Filed as: MELITA MCDONALD INSURANCE SERVICES | 50 W SAN FERNANDO ST STE 1350 SAN JOSE, CA 95113 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $31 | $0 | $31 | 0.77% |
| MELITA-MCDONALD INSURANCE SERVICES3 Filed as: MELITA INSURANCE AGENCY | PO BOX 610250 SAN JOSE, CA 95161 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $75 | $0 | $75 | 12.06% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2121 N CALIFORNIA BLVD # 1000 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18 | $0 | $18 | 2.89% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 18100 VON KARMAN AVE FL 10 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 0.16% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 193 | $239K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 457 | $19K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 457 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $65K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $22K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 457 | — |
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.