| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | BLUE CROSS OF CALIFORNIA | $4K | $0 | $4K | 1.75% |
| LUMITY, INC.3 Filed as: LUMITY INC. | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | BLUE CROSS OF CALIFORNIA | $4K | $0 | $4K | 1.67% |
| LUMITY, INC.3 Filed as: LUMITY INC. | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 2.43% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 1.95% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $50 | $2K | 4.52% |
| LUMITY, INC.3 Filed as: LUMITY INC. | PO BOX 207733 DALLAS, TX 75320 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $57 | $2K | 4.29% |
| LUMITY, INC.3 Filed as: LUMITY INC. | PO BOX 207733 DALLAS, TX 75320 | METLIFE LEGAL PLANS | $69 | $0 | $69 | 5.87% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE WALNUT CREEK, CA 94596 | METLIFE LEGAL PLANS | $46 | $0 | $46 | 3.91% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 85 | $291K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $41K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $41K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $41K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 85 | $291K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 140 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.