| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLAREMONT BUSINESS GROUP3 | 1000 BURNETT AVE. SUITE 440 CONCORD, CA 94520 | CALIFORNIA PHYSICIANS' SERVICE | — | $45K | $45K | 2.00% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SERVICES WEST | 5260 N. PALM AVE. STE 400 FRESNO, CA 937042217 | CALIFORNIA PHYSICIANS' SERVICE | — | $31K | $31K | 1.39% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INSURANCE SVCS. | 1850 GATEWAY DR. STE 700 SAN MATEO, CA 944044067 | KAISER FOUNDATION HEALTH PLAN INC. | — | $1K | $1K | 0.17% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. - IL | 29840 NETWORK PL SUITE 700 CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | -$33 | — | -$33 | -0.00% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 944023766 | KAISER FOUNDATION HEALTH PLAN INC. | -$12K | — | -$12K | -1.81% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $53 | $3K | 1.37% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.86% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR. SUITE 700 SAN MATEO, CA 944044067 | METROPOLITAN LIFE INSURANCE COMPANY | — | $499 | $499 | 0.27% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SERVICES WEST | 2277 FAIR OAKS BLVD. STE. 250 SACRAMENTO, CA 958255538 | VISION SERVICE PLAN | — | — | $0 | 0.00% |
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 | 224 | 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) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 316 | $2.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 452 | $234K |
| Vision | VISION SERVICE PLAN | 200 | $39K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $186K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $186K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $186K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 316 | $2.9M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 452 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.