| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94003 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $68K | $4K | $72K | 2.06% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN INC | $29K | — | $29K | 2.97% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | CIGNA HEALTHCARE OF CALIFORNIA | $10K | — | $10K | 1.71% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | UNION SECURITY INSURANCE COMPANY | $15K | $12K | $27K | 5.48% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 4.42% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION INC. | $1K | — | $1K | 1.73% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | VISION SERVICE PLAN | $2K | — | $2K | 3.83% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $3K | — | $3K | 15.00% |
| EVELYN M. SHELTON4 | 2954 OAKLEY ROAD OAKLEY, CA 94561 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $787 | — | $787 | 6.71% |
| MARIA GALICIA4 | 3601 NIGHTINGALE DRIVE ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $532 | — | $532 | 4.53% |
| DUENAS ASSOCIATES LLC4 | 4638 COLUMBIA RIVER COURT SAN JOSE, CA 95136 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $284 | — | $284 | 2.42% |
| GLOBAL COMMUNICATION4 | 21890 HARROW AVENUE NORTH FOREST LAKE, MN 55025 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $87 | — | $87 | 0.74% |
| MJ INSURANCE4 Filed as: DALENE SAWYER AND VARIOUS AGENTS | 14926 GABLES END DRIVE ATHENS, AL 35613 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $60 | — | $60 | 0.51% |
| POM ENTERPRISES4 | PO BOX 1495 ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $45 | — | $45 | 0.38% |
| LORI LEWISON4 | 4301 WEST 57TH STREET, SUITE 126 SIOUX FALLS, SD 57108 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $32 | — | $32 | 0.27% |
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 | 673 | 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) | 673 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,299 | $5.1M |
| Dental | UNION SECURITY INSURANCE COMPANY | 648 | $502K |
| Vision | VISION SERVICE PLAN | 652 | $47K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 703 | $216K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 703 | $216K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 703 | $216K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,299 | $5.1M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 703 | $246K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,299 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.