| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAROEVICH, O'SHEA AND COGHLAN INS.3 | 44 MONTGOMERY STREET, SUITE 1700 SAN FRANCISCO, CA 94104 | BLUE CROSS OF CALIFORNIA | $11K | $0 | $11K | 0.96% |
| AMWINS3 Filed as: LISI INC. | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | BLUE CROSS OF CALIFORNIA | $0 | $5K | $5K | 0.43% |
| MAROEVICH, O'SHEA AND COGHLAN INS.3 | 425 MARKET STREET, SUITE 1030 SAN FRANCISCO, CA 94105 | BLUE CROSS OF CALIFORNIA | $631 | $0 | $631 | 0.06% |
| MAROEVICH, O'SHEA AND COGHLAN INS.3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $23K | $0 | $23K | 3.72% |
| MAROEVICH, O'SHEA AND COGHLAN INS.3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 16.61% |
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 | 195 | 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) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 224 | $1.8M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 224 | $1.2M |
| Vision | BLUE CROSS OF CALIFORNIA | 224 | $1.1M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 224 | $1.1M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 35 | $25K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 35 | $25K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 94 | $668K |
| Other | BLUE CROSS OF CALIFORNIA | 224 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.