| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELITA-MCDONALD INSURANCE SERVICES3 Filed as: MELITA MCDONALD INSURANCE SERVICES | PO BOX 610250 SAN JOSE, CA 95161 | ANTHEM BLUE CROSS | $76K | $0 | $76K | 2.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | ANTHEM BLUE CROSS | $25K | $0 | $25K | 0.67% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 5.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 9 E RIVER PARK PL E FL 3 FRESNO, CA 93720 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $55 | $4K | 1.96% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC | 5444 WESTHEIMER RD STE 900 HOUSTON, TX 77056 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $605 | $605 | 0.31% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $500 | $4K | 2.27% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 1.37% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.53% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 100 PINE STREET 11TH FLO0R SAN FRANCISCO, CA 94111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.47% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.54% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 100 PINE STREET 11TH FLO0R SAN FRANCISCO, CA 94111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.47% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610520 SAN JOSE, CA 95161 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.54% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 100 PINE STREET 11TH FLO0R SAN FRANCISCO, CA 94111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.46% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR ST 400 DALLAS, TX 75251 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.96% |
| MELITA-MCDONALD INSURANCE SERVICES3 | PO BOX 610250 SAN JOSE, CA 95161 | VISION SERVICE PLAN | $1K | $0 | $1K | 2.70% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $953 | $0 | $953 | 1.93% |
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 | 464 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 481 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 40 | $3.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 895 | $197K |
| Vision | VISION SERVICE PLAN | 382 | $49K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 162 | $63K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 162 | $63K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 162 | $55K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 162 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 895 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.