| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | BLUE CROSS OF CALIFORNIA | $86K | $1K | $87K | 2.80% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | $732 | $29K | 4.88% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD CONCORD, CA 945205200 | PRINCIPAL LIFE INSURANCE COMPANY | $40K | $4K | $44K | 11.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET BOSTON, MA 02109 | AETNA LIFE INSURANCE COMPANY | $28K | — | $28K | 15.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5668 CONCORD, CA 94524 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 3.80% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 945207924 | VISION SERVICE PLAN | $2K | — | $2K | 3.98% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 945207924 | VISION SERVICE PLAN | $881 | — | $881 | 5.91% |
| MASOLI LEGACY LLC4 | 588 ALEXIS CIRCLE DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $762 | — | $762 | 21.62% |
| MARIAH L MASOLI4 Filed as: MARIAH MASOLI | 588 ALEXIS CIRCLE DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $267 | — | $267 | 7.57% |
| BLUMICA BUSINESS SOLUTIONS4 | PMB271 3440 YOUNGFIELD STREET WHEAT RIDGE, CO 80033 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $107 | — | $107 | 3.04% |
| THE SAMSON GROUP4 | 18 GREENGATE COURT SANTA ROSA, CA 95409 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $29 | — | $29 | 0.82% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBUGH, PA | $318 | — | $318 | 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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 315 | $3.9M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 317 | $658K |
| Vision(3 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 109 | $248K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 317 | $392K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 317 | $392K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 317 | $392K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 86 | $597K |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 315 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.