| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | BLUE CROSS OF CALIFORNIA | $73K | — | $73K | 4.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 721 PARKER STREET, SUITE 200 ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $4K | — | $4K | 0.23% |
| WELL-PRO INSURANCE SOLUTIONS INC.3 | 9155 ARCHIBALD AVE., SUITE H RANCHO CUCAMONGA, CA 91730 | BLUE CROSS OF CALIFORNIA | $4K | — | $4K | 0.23% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | $2K | $22K | 4.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 721 PARKER STREET, SUITE 200 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | $17 | $2K | 0.41% |
| WELL-PRO INSURANCE SOLUTIONS INC.3 | 756 S. WALNUT AVE. SAN DIMAS, CA 91773 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 0.40% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | $1K | $13K | 4.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 721 PARKER STREET, SUITE 200 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | $11 | $1K | 0.44% |
| WELL-PRO INSURANCE SOLUTIONS INC.3 | 756 S. WALNUT AVE. SAN DIMAS, CA 91773 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 0.44% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 4.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 721 PARKER STREET, SUITE 200 ORANGE, CA 92868 | ANTHEM LIFE INSURANCE COMPANY | $60 | — | $60 | 0.23% |
| WELL-PRO INSURANCE SOLUTIONS INC.3 | 9155 ARCHIBALD AVE., SUITE H RANCHO CUCAMONGA, CA 91730 | ANTHEM LIFE INSURANCE COMPANY | $60 | — | $60 | 0.23% |
| MELITA-MCDONALD INSURANCE SERVICES3 | 50 W. SAN FERNANDO ST., SUITE 1350 SAN JOSE, CA 95113 | VISION SERVICE PLAN | $1K | — | $1K | 4.64% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 721 PARKER STREET, SUITE 300 ORANGE, CA 92868 | VISION SERVICE PLAN | $62 | — | $62 | 0.27% |
| WELL-PRO INSURANCE SOLUTIONS INC.3 | 9155 ARCHIBALD AVE., SUITE H RANCHO CUCAMONGA, CA 91730 | VISION SERVICE PLAN | $62 | — | $62 | 0.27% |
| MELITA-MCDONALD INSURANCE SERVICES3 | P.O. BOX 610520 SAN JOSE, CA 95161 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $618 | — | $618 | 4.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 721 S. PARKER STREET, SUITE 200 ORANGE, CA 92868 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $31 | — | $31 | 0.23% |
| WELL-PRO INSURANCE SOLUTIONS INC.3 | 9155 ARCHIBALD AVE., SUITE H RANCHO CUCAMONGA, CA 91730 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $31 | — | $31 | 0.23% |
| MELITA-MCDONALD INSURANCE SERVICES3 | 50 W. SAN FERNANDO ST., SUITE 1350 SAN JOSE, CA 95113 | HARTFORD LIFE AND ACCIDENT | $322 | — | $322 | 14.98% |
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 | 209 | 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) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $2.4M |
| Vision | VISION SERVICE PLAN | 195 | $23K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 209 | $16K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 209 | $26K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 209 | $28K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 116 | $2.4M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 209 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.