| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 2745 WEST 600 NORTH LINDON, UT 84042 | BLUE CROSS OF CALIFORNIA | $6K | $0 | $6K | 3.81% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES, LLC | 2677 NORTH MAIN STREET SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $0 | $3K | $3K | 2.24% |
| A & COMPANY, INC.3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | $3K | $0 | $3K | 2.17% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.55% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES, LLC | 2677 NORTH MAIN STREET SANTA ANA, CA 92705 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.85% |
| ANDREINI AND COMPANY3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.44% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: NATIONAL PCF BONUS ONLY | 2500 WEST EXECUTIVE PARKWAY SUITE 200 LEHI, UT 84043 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.78% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 5.07% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 24 | $212K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $70K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $70K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $70K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 11 | $59K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 151 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.