| 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. | $61K | — | $61K | 2.26% |
| INTRINSIC SOLUTIONS INSURANCE3 Filed as: INTRINSIC SOLUTIONS INSUR | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $59K | — | $59K | 13.60% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $20K | $20K | 4.53% |
| ESTRADA ENTERPRISES LLC3 | 5340 EDGEVIEW DRIVE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $26 | $5K | 11.07% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.47% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $939 | $17 | $956 | 2.26% |
| WENDY SUE GERSHOW3 | 3217 STAR AVENUE OAKLAND, CA 94619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $679 | $10 | $689 | 1.63% |
| BRUCE NAM NGUYEN3 | 207 PEPPERMINT TREE TERRACE UNIT 9 SUNNYVALE, CA 94086 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $270 | $387 | $657 | 1.55% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $178 | — | $178 | 0.42% |
| DEAN LOUIS GRANT3 | 1874 DREW AVENUE MOUNTAIN VIEW, CA 94043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | $2 | $99 | 0.23% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $26 | $95 | 0.22% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVENUE APARTMENT A SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | — | $87 | 0.21% |
| EDGEWATER INSURANCE SOLUTIONS LLC3 | 11 HUMBOLDT COURT PACIFICA, CA 94044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $25 | $75 | 0.18% |
| MARK JOHN KANITRA3 | 1009 SOUTH RISING SUN COURT ANAHEIM, CA 92808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.11% |
| VONDA KAY PERALEZ3 | 6409 RIO DE JANEIRO AVENUE BAKERSFIELD, CA 93313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| JAN HEJRET3 | 644 NORTH 17TH STREET SAN JOSE, CA 95112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $7 | $10 | 0.02% |
| NICHOLAS RYAN DERRICO3 | 1745 WEST ORANGEWOOD AVENUE SUITE 212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.01% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.01% |
| LORI ROBIN NISHIMORI3 | 9204 HOXIE COURT BAKERSFIELD, CA 93311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| INTRINSIC SOLUTIONS INSURANCE3 Filed as: INTRINSIC SOLUTIONS AGENCY LLC | — | MEDICAL AIR SERVICES ASSOCIATION, INC. | $2K | — | $2K | 8.34% |
| MASA AGENTS3 | — | MEDICAL AIR SERVICES ASSOCIATION, INC. | $2K | — | $2K | 8.31% |
| CLIFFORD FRANKLIN BROOKS3 Filed as: CLIFFORD DER | — | MEDICAL AIR SERVICES ASSOCIATION, INC. | $1K | — | $1K | 4.09% |
| MASOLI LEGACY LLC3 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 19.44% |
| INTRINSIC SOLUTIONS INSURANCE3 | 1968 SOUTH COAST HIGHWAY LAGUNA BEACH, CA 92651 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 10.89% |
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 | 386 | 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) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 506 | $2.7M |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 386 | $431K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 386 | $431K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 386 | $431K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 506 | $2.7M |
| Stop-loss / reinsurancereinsurance | CRUM & FORSTER | 204 | $1.7M |
| Other(4 contracts, 4 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 386 | $510K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 506 | — |
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.