| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $26K | $0 | $26K | 2.25% |
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 7.22% |
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 7.18% |
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| PROFESSIONAL GROUP PLAN, INC3 | 225 WIRELESS BLVD HAPPAUGE, NY 11788 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $845 | — | $845 | 9.99% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $607 | $607 | 7.18% |
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $768 | — | $768 | 20.01% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $348 | $348 | 9.07% |
| UBF INSURANCE SERVICES, INC.3 | 2033 N. MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $715 | — | $715 | 20.01% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $322 | $322 | 9.01% |
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 | 260 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 186 | $1.2M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 377 | $23K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 260 | $60K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 260 | $8K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 260 | $43K |
| Other(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 260 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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.