| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN ST 21ST FLOOR SAN FRANCISCO, CA 94105 | CALIFORNIA PHYSICIAN'S SERVICE | — | $50K | $50K | 5.91% |
| WELDON G KERR3 | RBG SAN JOSE 6155 ALMADEN EXPWY#210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIAN'S SERVICE | — | $17K | $17K | 2.03% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 5.10% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 94104 | DELTA DENTAL OF CALIFORNIA | $10K | — | $10K | 10.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94520 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $691 | $9K | 10.41% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 8000 NORMAN CETNER DR. STE 605 BLOOMINGTON, MN 554371178 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $821 | $5K | 5.63% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 669 RIVER DR. STE 305 ELMWOOD PARK, NJ 074071361 | METROPOLITAN LIFE INSURANCE COMPANY | $95 | — | $95 | 0.11% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 4675 MACARTHUR CT STE 750 NEWPORT BEACH, CA 926608891 | METROPOLITAN LIFE INSURANCE COMPANY | — | $30 | $30 | 0.03% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N 40TH ST STE 234 PHOENIX, AZ 850182151 | VISION SERVICE PLAN | $355 | — | $355 | 2.70% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DR CENTER II STE 30 ELMWOOD PARK, NJ 07407 | VISION SERVICE PLAN | $345 | — | $345 | 2.63% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94524 | HOLMAN FAMILY COUNSELING, INC. | $154 | — | $154 | 4.98% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN, INC. | $418 | — | $418 | 37.22% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 75 | $1.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 144 | $96K |
| Vision | VISION SERVICE PLAN | 67 | $13K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 97 | $89K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 97 | $89K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 97 | $89K |
| Prescription drug(3 contracts, 2 carriers) | CALIFORNIA PHYSICIAN'S SERVICE | 75 | $1.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.