| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $54K | $0 | $54K | 5.02% |
| USI INSURANCE SERVICES LLC3 | 333 SOUTH GRAND AVENUE, SUITE 1450 LOS ANGELES, CA 90071 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 13.37% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BOULEVARD, SUITE 400 BURLINGAME, CA 94010 | AFLAC | $4K | $292 | $4K | 8.89% |
| WALTER O. PECCORINI3 Filed as: WALTER O. PECCORINI & OTHER AGENTS | 708 WEST SWAIN ROAD STOCKTON, CA 95207 | AFLAC | $1K | $0 | $1K | 2.14% |
| GABRIEL LUCAS3 | 218 7TH AVENUE, APARTMENT 105 SAN MATEO, CA 94401 | AFLAC | $920 | $38 | $958 | 2.03% |
| MICHAELA K. DONOFRIO3 | 2609 JUDAH STREET, APARTMENT 10 SAN FRANCISCO, CA 94122 | AFLAC | $292 | $187 | $479 | 1.02% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DRIVE SANTA ROSA, CA 95403 | AFLAC | $289 | $95 | $384 | 0.81% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: MATTHEW DOMINIC BROWN | 490 43RD STREET, SUITE 1009 OAKLAND, CA 94609 | AFLAC | $337 | $0 | $337 | 0.72% |
| JOSEPH J. FOGEL3 | 621 HOLLOWAY AVENUE SAN FRANCISCO, CA 94112 | AFLAC | $231 | $10 | $241 | 0.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $453 | $2K | 15.83% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, INC. | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $47 | $47 | 0.45% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST VEVA 16, SUITE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $30 | $30 | 0.29% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 138 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $69K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $69K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 165 | $10K |
| Short-term disability | AFLAC | 40 | $47K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 138 | $1.1M |
| Other(2 contracts, 2 carriers) | AFLAC | 165 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.