| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | CALIFORNIA PHYSICIANS SERVICE | $34K | $127K | $161K | 6.05% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC. | $70K | — | $70K | 4.25% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $15K | — | $15K | 7.17% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $10K | — | $10K | 4.71% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $16K | — | $16K | 8.53% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O.BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $10K | — | $10K | 5.02% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 4.98% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O.BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | — | $7K | 4.70% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $9K | — | $9K | 6.96% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 4.65% |
| THE BALDWIN GROUP WEST LLC3 Filed as: BALDWIN GROUP WEST LLC | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AMERICAN FIDELITY ASSURANCE COMPANY | $235 | — | $235 | 0.18% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $12K | — | $12K | 11.98% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.90% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $8K | — | $8K | 11.70% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O.BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.73% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $5K | — | $5K | 14.99% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O.BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 4.75% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $760 | — | $760 | 2.94% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 102159 PASADENA, CA 91189 | AMERICAN FIDELITY ASSURANCE COMPANY | $457 | — | $457 | 5.38% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $160 | — | $160 | 1.88% |
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 | 772 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 775 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(10 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 293 | $5.2M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 293 | $2.7M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 293 | $2.7M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 659 | $31K |
| Short-term disability(8 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 121 | $890K |
| Long-term disability(8 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 121 | $890K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 293 | $4.3M |
| Other(9 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 659 | $922K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 659 | — |
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.