| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 180 HOWARD STREET SUITE 200 SAN FRANCISCO, CA 94105 | BLUE CROSS OF CALIFORNIA | $62K | $0 | $62K | 4.36% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $29K | $0 | $29K | 4.98% |
| HEFFERNAN INSURANCE BROKERS3 Filed as: HEFFERNAN INSURANCE BROKRERS | 5100 S MACADAM SUITE 440 PORTLAND, OR 97239 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 2.54% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $8K | $0 | $8K | 4.79% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43603 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.63% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | $0 | $2K | 5.26% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.00% |
| JUDI JONES3 Filed as: JUDI P JONES | 4583 HARMONY PL ROHNERT PARK, CA 94928 | AFLAC | $2K | $129 | $2K | 23.46% |
| MARK C. HUBER3 Filed as: MARK C HUBER | 4164 LEISURE LANE PLACERVILLE, CA 95667 | AFLAC | $186 | $16 | $202 | 2.44% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DRIVE SANTA ROSA, CA 95403 | AFLAC | $119 | $26 | $145 | 1.75% |
| MARK C. HUBER3 Filed as: MARK C HUBER | 1260 N DUTTON AVE SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $125 | $10 | $135 | 1.63% |
| DANIEL BAKLEY3 | 8148 SEDONA SUNSET DRIVE LAS VEGAS, NV 89128 | AFLAC | $128 | $0 | $128 | 1.54% |
| JAYDA M ZEMANSKY3 | 1132 LAKEVILLE CIRC PETALUMA, CA 94954 | AFLAC | $99 | $0 | $99 | 1.19% |
| SAHAR QABAZARD3 | 3756 DEER TRAIL CT DANVILLE, CA 94506 | AFLAC | $86 | $0 | $86 | 1.04% |
| LOUIS CHANDLER CASTLEBERRY3 | 1150 VILLAGE WAY SEBASTOPOL, CA 95472 | AFLAC | $55 | $0 | $55 | 0.66% |
| SHANE EDMUND ATTEBERY3 Filed as: SHANE EDMUND ATTEBERRY | 391 RANDY DRIVE GRANTS PASS, OR 97527 | AFLAC | $24 | $0 | $24 | 0.29% |
| ROBERT PILKENTON3 | 6643 FM 2187 ROAD SEALY, TX 77474 | AFLAC | $3 | $0 | $3 | 0.04% |
| LISA M HUTCHERSON3 | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $1 | $0 | $1 | 0.01% |
| DAVID B. KITCHEN3 Filed as: DAVID B KITCHEN | 1260 N DUTTON AVE SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $1 | $0 | $1 | 0.01% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $634 | $0 | $634 | 10.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONAL BENEFIT SERVICES, LLC EIN 20-3886993 FSA ADMIN | Claims processing Service code 12 | — | $959 |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 149 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 225 | $191K |
| Vision | VISION SERVICE PLAN | 205 | $52K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 109 | $6K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 109 | $10K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 109 | $11K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 149 | $2.2M |
| Other(2 contracts, 2 carriers) | AFLAC | 109 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.