| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | BLUE CROSS OF CALIFORNIA | $85K | — | $85K | 4.20% |
| AMWINS3 Filed as: LISI INC. | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $38K | $38K | 1.90% |
| WELLS FARGO INSURANCE SERVICES3 | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | BLUE CROSS OF CALIFORNIA | $11K | — | $11K | 0.55% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 N. CALIFORNIA BLVD, SUITE 1000 WALNUT CREEK, CA 94596 | DELTA DENTAL OF CALIFORNIA | $24K | — | $24K | 8.97% |
| WELLS FARGO INSURANCE SERVICES3 | UNKNOWN EMERYVILLE, CA 94608 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 1.03% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 N. CALIFORNIA BLVD, SUITE 1000 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 3.86% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 N. CALIFORNIA BLVD, SUITE 1000 WALNUT CREEK, CA 94596 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 11.06% |
| WELLS FARGO INSURANCE SERVICES3 | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $2K | $4K | 2.90% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $1K | — | $1K | 2.95% |
| WELLS FARGO INSURANCE SERVICES3 | 959 SKYWAY ROAD, SUITE 200 SAN CARLOS, CA 94070 | VISION SERVICE PLAN | $444 | — | $444 | 1.06% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 100 PINE STREET SAN FRANCISCO, CA 94111 | ACE AMERICAN INSURANCE COMPANY | $451 | — | $451 | 15.00% |
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 | 326 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 614 | $2.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 745 | $265K |
| Vision | VISION SERVICE PLAN | 264 | $42K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $136K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $136K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $136K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 614 | $2.3M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 745 | — |
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.