| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOMINE, JOSEPH3 | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | BLUE CROSS OF CALIFORNIA | $147K | — | $147K | 5.83% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | SERVICES LLC 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $11K | $11K | 0.45% |
| JOSEPH DOMINE3 | 257 N 1ST ST SAN JOSE, CA 951131014 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 3.77% |
| JOSEPH DOMINE3 | 257 NORTH 1ST STREET SAN JOSE, CA 95113 | DELTA | $29K | — | $29K | 10.00% |
| JOSEPH DOMINE3 | 257 N 1ST ST SAN JOSE, CA 951131014 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 4.53% |
| JOE DOMINE3 | 257 N 1ST ST SAN JOSE, CA 951131014 | VISION SERVICE PLAN | $2K | — | $2K | 4.10% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA | EASECENTRAL 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 891352958 | VISION SERVICE PLAN | $507 | — | $507 | 1.26% |
| ESTRADA ENTERPRISES LLC3 Filed as: ESTRADA ENTREPRISES LLC | 5340 EDGEVIEW DRIVE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.51% |
| JOSEPH DOMINE3 Filed as: JOSEPH ERNEST DOMINE | 257 N. 1ST STREET SAN JOSE, CA 95113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.42% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.93% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE CT HERCULES, CA 94547 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $785 | — | $785 | 2.18% |
| CATHERINE LISA LUKE3 | 4787 W HACIENDA AVE CAMPBELL, CA 95008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $424 | $1 | $425 | 1.18% |
| BRUCE NAM NGUYEN3 | 207 PEPPERMINT TREE TER UNIT 9 SUNNYVALE, CA 94086 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $173 | $187 | 0.52% |
| GILBERTO ESTRADA SR3 | 4084 BEACON PLACE DISCOVERY BAY, CA 94505 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $159 | — | $159 | 0.44% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVE SAN MATEO, CA 94402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $3 | $67 | 0.19% |
| NICHOLAS RYAN DERRICO3 | 1745 W ORANGEWOOD AVE STE #212 ORANGE, CA 92868 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $8 | $15 | 0.04% |
| DEAN LOUIS GRANT3 | 1874 DREW AVE MOUNTAIN VIEW, CA 94043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $6 | $10 | 0.03% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| MARK JOHN KANITRA3 | 1009 S. RISING SUN COURT ANAHEIM, CA 92808 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| YOLO ENTERPRISE INC3 | 5460 E EL PRAQUE ST LONG BEACH, CA 90815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 290 | $3.1M |
| Dental | DELTA | 187 | $292K |
| Vision | VISION SERVICE PLAN | 199 | $40K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 290 | $2.5M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 290 | $2.6M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 290 | $2.5M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 290 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.