| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELITA-MCDONALD INSURANCE SERVICES3 Filed as: MELITA MCDONALD INSURANCE SERVICES | PO BOX 610520 SAN JOSE, CA 95161 | BLUE CROSS OF CALIFORNIA | $53K | $22K | $76K | 4.04% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | BLUE CROSS OF CALIFORNIA | $19K | $286 | $19K | 1.02% |
| MELITA-MCDONALD INSURANCE SERVICES3 Filed as: MELITA MCDONALD INSURANCE SERVICES | PO BOX 610520 SAN JOSE, CA 95161 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 2.97% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 1.30% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES INC (GA) | 1350 TREAT BLVD STE 470 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $408 | $0 | $408 | 0.09% |
| MELITA-MCDONALD INSURANCE SERVICES3 Filed as: MELITA MCDONALD INSURANCE SERVICES | 50 WEST SAN FERNANDO ST SUITE 1350 SAN JOSE, CA 95113 | THE GUARDIAN LIFE INSURANCE COMPANY | $12K | $420 | $12K | 5.49% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2185 NORTH CALIFORNIA BLVD SUITE 400 WALNUT CREEK, CA 94596 | THE GUARDIAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 2.70% |
| PACIFIC ADVISORS LLC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY | $727 | $0 | $727 | 0.33% |
| MELITA-MCDONALD INSURANCE SERVICES3 Filed as: MELITA MCDONALD INSURANCE SERVICES | PO BOX 610520 SAN JOSE, CA 95161 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $747 | $9K | 7.55% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | SAN FRANCISCO 701 B ST FL 6 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 3.10% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES, INC | 500 YGNACIO VALLEY RD STE 450 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $989 | $0 | $989 | 5.09% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | VISION SERVICE PLAN | $856 | $0 | $856 | 4.41% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $311 | $0 | $311 | 1.60% |
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 | 228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 432 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 264 | $218K |
| Vision | VISION SERVICE PLAN | 245 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $116K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $116K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $116K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 272 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 432 | — |
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.