| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | BLUE CROSS OF CALIFORNIA | $43K | $17 | $43K | 5.28% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVAS | 1350 TREAT BLVD, SUITE 470 WALNUT CREEK, CA 94597 | BLUE CROSS OF CALIFORNIA | — | $17K | $17K | 2.12% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | KAISER FOUNDATION HEALTH PLAN INC. | $16K | — | $16K | 5.16% |
| MELITA-MCDONALD INSURANCE SERVICES3 | 50 W. SAN FERNANDO ST., SUITE 1350 SAN JOSE, CA 95113 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $10K | — | $10K | 8.00% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.28% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVAS | 1350 TREAT BLVD, SUITE 470 WALNUT CREEK, CA 94597 | ANTHEM LIFE INSURANCE COMPANY | — | $562 | $562 | 2.13% |
| MELITA-MCDONALD INSURANCE SERVICES3 | 50 W. SAN FERNANDO ST., SUITE 1350 SAN JOSE, CA 95113 | VISION SERVICE PLAN | $1K | — | $1K | 4.78% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $810 | — | $810 | 5.28% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVAS | 1350 TREAT BLVD, SUITE 470 WALNUT CREEK, CA 94597 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $326 | $326 | 2.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 GUTHRIE LANE, STE.22 BRENTWOOD, CA 94513 | ACE AMERICAN INSURANCE COMPANY | $609 | — | $609 | 20.00% |
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 | 90 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 61 | $1.1M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 84 | $120K |
| Vision | VISION SERVICE PLAN | 85 | $25K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 90 | $15K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 90 | $26K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 90 | $26K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 61 | $1.1M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 268 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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.