| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | CALIFORNIA PHYSICIANS' SERVICE | — | $48K | $48K | 5.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 S. PARKER STEET, 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | $19K | — | $19K | 2.11% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 4.51% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $616 | $5K | 11.64% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. | 721 PARKER STREET, SUITE 140 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $640 | $2K | 5.63% |
| ARROW BENEFITS GROUP3 Filed as: ARROW | PO BOX 750004 PETALUMA, CA 94975 | PRINCIPAL LIFE INSURANCE COMPANY | — | $233 | $233 | 0.59% |
| TRUE NETWORK ADVISORS3 | 1513 AMBER LANE GUNTERSVILLE, AL 35976 | PRINCIPAL LIFE INSURANCE COMPANY | — | $65 | $65 | 0.17% |
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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 148 | $1.1M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 214 | $39K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 214 | $39K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 214 | $39K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 148 | $1.1M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 214 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.