| 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. | $45K | $0 | $45K | 4.33% |
| USI INSURANCE SERVICES LLC3 | 7535 IRVINE CENTER DRIVE, SUITE 250 IRVINE, CA 92618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $9K | 12.00% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BOULEVARD, SUITE 400 BURLINGAME, CA 94010 | AFLAC | $2K | $37 | $2K | 5.64% |
| MICHAELA K. DONOFRIO3 | 253 GOLD MINE DRIVE SAN FRANCISCO, CA 94131 | AFLAC | $1K | $42 | $1K | 3.67% |
| MJ INSURANCE3 Filed as: JULIE ATKINS AND VARIOUS AGENTS | 16321 PACIFIC COAST HIGHWAY SPACE 6 PACIFIC PALISADES, CA 90272 | AFLAC | $787 | $0 | $787 | 2.11% |
| DANIELLE SCHALL3 | 789 17TH AVENUE MENLO PARK, CA 94025 | AFLAC | $430 | $0 | $430 | 1.15% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DRIVE SANTA ROSA, CA 95403 | AFLAC | $254 | $14 | $268 | 0.72% |
| JOSEPH J. FOGEL3 | 2390 31ST AVENUE, APARTMENT 104 SAN FRANCISCO, CA 94116 | AFLAC | $248 | $0 | $248 | 0.66% |
| WALTER O. PECCORINI3 | 708 WEST SWAIN ROAD STOCKTON, CA 95207 | AFLAC | $223 | $0 | $223 | 0.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $332 | $1K | 16.96% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 141 | $1.0M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $110K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 105 | $110K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 143 | $46K |
| Short-term disability | AFLAC | 54 | $37K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 141 | $1.0M |
| Other(2 contracts, 2 carriers) | AFLAC | 143 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.