| 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 94403 | BLUE CROSS OF CALIFORNIA | $5K | $0 | $5K | 4.72% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | $0 | $2K | $2K | 1.38% |
| MCGRIFF INSURANCE SERVICES INC3 | 1104 AMHERST STREET WINCHESTER, VA 22601 | BLUE CROSS OF CALIFORNIA | -$140 | $0 | -$140 | -0.12% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B STREET, SUITE 2400 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $418 | $0 | $418 | 1.33% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 10.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | VISION SERVICE PLAN | $97 | $0 | $97 | 7.28% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 280 | $145K |
| Dental | STANDARD INSURANCE COMPANY | 119 | $17K |
| Vision(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 120 | $18K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $11K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $11K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $11K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 280 | $145K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.