| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 3 EMBARCADERO CENTER, SUITE 600 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $41K | $0 | $41K | 2.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $26K | $0 | $26K | 1.42% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 STONY POINT ROAD SANTA ROSA, CA 95401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $121 | $2K | 5.23% |
| ALAYNE MATA3 | 3276 KATHY WAY LOOMIS, CA 95650 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $13 | $2K | 5.22% |
| ANN MARIE BLEDSOE3 | PO BOX 951 WOODACRE, CA 94973 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 4.29% |
| LAURA RUNYEON3 Filed as: LAURA RUNYEON AND OTHER AGENTS | 2042 WEATHERBY WAY PETALUMA, CA 94954 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $200 | $45 | $245 | 0.78% |
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION AVENUE DENVER, CO 80237 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $225 | $0 | $225 | 0.72% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $146 | $67 | $213 | 0.68% |
| DARRYL W VIDOR3 Filed as: DARRYL W. VIDOR | 3314 EUROPA STREET ROSEVILLE, CA 95661 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $178 | $0 | $178 | 0.57% |
| LOCKTON COMPANIES, LLC3 | 635 BROADWAY SONOMA, CA 95476 | AMERITAS LIFE INSURANCE CORPORATION | $953 | $0 | $953 | 6.23% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1950 WEST CORPORATE WAY, SUITE 1 ANAHEIM, CA 92801 | AMERITAS LIFE INSURANCE CORPORATION | $577 | $67 | $644 | 4.21% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $242 | $242 | 1.58% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 231 | $1.8M |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 248 | $15K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 231 | $1.8M |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 96 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.