| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELITA-MCDONALD INSURANCE SERVICES3 | 75 E SANTA CLARA ST, SUITE 1200 SAN JOSE, CA 95113 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $160K | — | $160K | 5.00% |
| WELDON G KERR3 | RBG SAN JOSE 6155 ALMADEN EXPWY #210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $96K | — | $96K | 3.00% |
| MELITA-MCDONALD INSURANCE SERVICES3 | 75 E SANTA CLARA ST, SUITE 1200 SAN JOSE, CA 95113 | DELTA DENTAL OF CALIFORNIA | $24K | — | $24K | 10.00% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 4.91% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 9.99% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $452 | $452 | 0.96% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | VISION SERVICE PLAN | $1K | — | $1K | 4.49% |
| ENROLLEASE3 Filed as: ENROLLEASE, IND DBA EASECENTRAL | 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $409 | — | $409 | 1.25% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 9.99% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $225 | $225 | 0.97% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $917 | — | $917 | 9.99% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $90 | $90 | 0.98% |
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 | 137 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 359 | $3.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 415 | $240K |
| Vision | VISION SERVICE PLAN | 137 | $33K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $47K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 359 | $3.3M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 415 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.