| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GRANITE PROFESSIONAL INSURANCE3 | BROKERAGE INC. 360 LINDBERGH AVE LIVERMORE, CA 945519511 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | — | $16K | 4.80% |
| GRANITE PROFESSIONAL INSURANCE3 | BROKERAGE 360 LINDBERGH AVE LIVERMORE, CA 945519511 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 5.50% |
| GRANITE PROFESSIONAL INSURANCE3 | BROKERS INC 6600 KOLL CENTER PKWY #100 PLEASANTON, CA 94566 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | — | $7K | 4.83% |
| LORI LAINE3 | 34676 CONADRIA AVE YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $5K | $9K | 10.28% |
| GRANITE PROFESSIONAL INSURANCE3 Filed as: GRANITE PROFESSIONAL INSURANCE BROK | 6600 KOLL CENTER PARKWAY PLEASANTON, CA 94566 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 8.33% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $211 | $2K | 2.36% |
| CLARICE R MIMS3 | 133 HILLCREST DRIVE MARLBORO, NY 12542 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $248 | $2K | 2.29% |
| RNM SERVICES INC3 | 15833 SARAH RIDGE RD SAN DIEGO, CA 92127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $323 | $840 | $1K | 1.39% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $616 | $335 | $951 | 1.13% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | $330 | $470 | 0.56% |
| BRETT WELTY INSURANCE AGENCY INC3 | 10769 WOODSIDE AVE STE 103 SANTEE, CA 92071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $438 | — | $438 | 0.52% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE SPC 112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $348 | $75 | $423 | 0.50% |
| WILLIAM RYAN KELLY3 | 515 CERRITOS WAY CATHEDRAL CITY, CA 92234 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | $243 | $369 | 0.44% |
| MICHELLE KAYE LUBICH3 | 12584 14TH ST YUCAIPA, CA 92399 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $324 | — | $324 | 0.39% |
| CLIENT BENEFIT INSURANCE SERVICES3 Filed as: CLIENT BENEFIT INSURANCE SERVICES I | 10769 WOODSIDE AVE SANTEE, CA 92071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $206 | — | $206 | 0.25% |
| MARGARITA ALEJANDRA RAMIREZ3 | 1356 CALLE COLNETT SAN MARCOS, CA 92069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | $52 | $195 | 0.23% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DR SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $160 | — | $160 | 0.19% |
| MATTHEW WELTY INSURANCE AGENCY INC3 | 5675 RUFFIN RD STE 150 SAN DIEGO, CA 92123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $135 | — | $135 | 0.16% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS DOW | 555 FAIRMOUNT AVENUE BALTIMORE, MD 21286 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.08% |
| MULLANEY ENTERPRISES LLC3 | 5501 TWIN KNOLLS RD STE 106 COLUMBIA, MD 21045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.07% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $19 | $48 | 0.06% |
| GREG W WOOLLEY3 | 15492 CLIFFVIEW DR MONTCLAIR, VA 22025 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.03% |
| MARTHA ANGELICA HILL ESTRADA3 | 2991 ESCALA CIR SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.03% |
| LILIANA RIVERA3 | 1267 SILVER TORCH DR BEAUMONT, CA 92223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $3 | $19 | 0.02% |
| ERIS VENTURES LLC3 | 931 MONROE DR NE STE A102 ATLANTA, GA 30308 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| MICHAEL JAMES LEBRANE3 | 808 E 5TH AVE APT A SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| MICHAEL F FAHEY III3 | 103 PALM DR SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $1 | $12 | 0.01% |
| CHARLES HILLIARD SHEPPARD3 | 4617 ARMLEY PT PEACHTREE CORNERS, GA 30092 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| ERNESTO MCKENZIE JR3 | 9210 TOMS TRL LAUREL, MD 20723 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| JOEL N NEWMAN AGENCY LLC3 | 924-B NW 52ND ST SEATTLE, WA 98107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| MARKS BENEFIT MANAGEMENT LLC3 | 3847 E SPYGLASS HILL DR FAYETTEVILLE, AR 72701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DR OAKDALE, CA 95361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 46 | $489K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $154K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $154K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 52 | $84K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 52 | $84K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 627 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 627 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.