| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOMINE, JOSEPH3 | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | BLUE CROSS OF CALIFORNIA | $85K | — | $85K | 5.57% |
| AMWINS3 Filed as: LISI LLC | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $7K | $7K | 0.45% |
| JOSEPH DOMINE3 | 257 N 1ST ST SAN JOSE, CA 951131014 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 4.32% |
| JOSEPH DOMINE3 | 257 N 1ST ST SAN JOSE, CA 951131014 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 4.59% |
| JOSEPH DOMINE3 | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | DELTA DENTAL | $22K | — | $22K | 10.00% |
| JOSEPH DOMINE3 Filed as: JOSEPH E DOMINE | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 5.84% |
| JOSEPH DOMINE3 Filed as: JOSEPH E DOMINE | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 9.77% |
| JOE DOMINE3 | 257 N 1ST ST SAN JOSE, CA 951131014 | VISION SERVICE PLAN | $1K | — | $1K | 4.84% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA | EASECENTRAL 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 891352958 | VISION SERVICE PLAN | $90 | — | $90 | 0.32% |
| JOSEPH DOMINE3 Filed as: JOSEPH E DOMINE | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.48% |
| JOSEPH DOMINE3 Filed as: JOSEPH ERNEST DOMINE | 257 N 1ST STREET SAN JOSE, CA 95113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 14.59% |
| GILBERTO ESTRADA SR3 | 4084 BEACON PLACE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 10.94% |
| CHRISTINA ALTOMARE ESTRADA3 | 1692 CRESCENT DRIVE WALNUT CREEK, CA 94598 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $102 | $2K | 8.97% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE CT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $664 | $16 | $680 | 3.71% |
| CATHERINE LISA LUKE3 | 4787 W HACIENDA AVE CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $379 | $147 | $526 | 2.87% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $249 | $42 | $291 | 1.59% |
| YOLO ENTERPRISE INC3 | 5460 E EL PRAQUE ST LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $3 | $23 | 0.13% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.11% |
| KEVIN LEE SURLES SR3 | 376 SAN DIEGO AVE DALY CITY, CA 94014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 239 | $2.0M |
| Dental | DELTA DENTAL | 124 | $218K |
| Vision | VISION SERVICE PLAN | 138 | $28K |
| Life insurance | STANDARD INSURANCE COMPANY | 154 | $54K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 154 | $39K |
| Long-term disability | STANDARD INSURANCE COMPANY | 154 | $52K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 17 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.