| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTRINSIC SOLUTIONS INSURANCE3 Filed as: INTRINSIC SOLUTIONS INSURANCE AGENC | 1968 SOUTH COAST HIGHWAY #2125 LAGUNA BEACH, CA 92651 | KAISER FOUNDATION HEALTH PLAN, INC. | $77K | — | $77K | 2.72% |
| INTRINSIC SOLUTIONS INSURANCE3 Filed as: INTRINSIC SOLUTIONS INSUR | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $79K | — | $79K | 16.24% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $26K | $26K | 5.41% |
| ESTRADA ENTERPRISES LLC3 | 5340 EDGEVIEW DRIVE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $262 | $13K | 18.03% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.15% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.92% |
| WENDY SUE GERSHOW3 | 3217 STAR AVENUE OAKDALE, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $30 | $2K | 2.06% |
| JAN HEJRET3 | 644 NORTH 17TH STREET SAN JOSE, CA 95112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $372 | $681 | $1K | 1.44% |
| EDGEWATER INSURANCE SOLUTIONS LLC3 | 11 HUMBOLDT COURT PACIFICA, CA 94044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $298 | $2 | $300 | 0.41% |
| MARK JOHN KANITRA3 | 1009 SOUTH RISING SUN COURT ANAHEIM, CA 92808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.20% |
| BRUCE NAM NGUYEN3 | 207 PEPPERMINT TREE TERRACE UNIT 9 SUNNYVALE, CA 94086 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $1 | $128 | 0.17% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $33 | $127 | 0.17% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | — | $127 | 0.17% |
| LAURA RUNYEON3 | 981 QUARRY STREET PETALUMA, CA 94954 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $18 | $110 | 0.15% |
| DEAN LOUIS GRANT3 | 1874 DREW AVENUE MOUNTAIN VIEW, CA 94043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| INTRINSIC SOLUTIONS INSURANCE3 Filed as: INTRINSIC SOLUTIONS AGENCY LLC | — | MEDICAL AIR SERVICES ASSOCIATION, INC. | $2K | — | $2K | 6.50% |
| MASOLI LEGACY LLC3 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 13.51% |
| INTRINSIC SOLUTIONS INSURANCE3 | 1968 SOUTH COAST HIGHWAY LAGUNA BEACH, CA 92651 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 7.61% |
| BENEFITS LLC SHIRAZI3 | 8205 WEST 20TH STREET GREELEY, CO 80634 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $54 | — | $54 | 0.35% |
| ESTRADA ENTERPRISES LLC3 | 5340 EDGEVIEW DRIVE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 7.66% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 3.18% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 1.87% |
| JAN HEJRET3 | 644 NORTH 17TH STREET SAN JOSE, CA 95112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $2 | $3 | 0.56% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.37% |
| EDGEWATER INSURANCE SOLUTIONS LLC3 | 11 HUMBOLDT COURT PACIFICA, CA 94044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.19% |
| MARK JOHN KANITRA3 | 1009 SOUTH RISING SUN COURT ANAHEIM, CA 92808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.19% |
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 | 461 | 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) | 461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 524 | $2.8M |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 457 | $486K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 457 | $486K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 457 | $486K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 524 | $2.8M |
| Stop-loss / reinsurancereinsurance | CRUM & FORSTER | 271 | $2.6M |
| Other(5 contracts, 4 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 457 | $611K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 524 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.