| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN C VO3 | 2024 NOTTOWAY AVENUE SAN JOSE, CA 95116 | BLUE SHIELD OF CALIFORNIA | — | $35K | $35K | 4.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 SOUTH PARKER STREET 8TH FLOOR ORANGE, CA 92868 | BLUE SHIELD OF CALIFORNIA | — | $16K | $16K | 2.11% |
| CLIFFORD FRANKLIN BROOKS3 Filed as: CLIFFORD DER | 40485 ENCYCLOPEDIA CIRCLE FREMONT, CA 94538 | BLUE SHIELD OF CALIFORNIA | — | $6K | $6K | 0.80% |
| JOHN VO3 | PO BOX 1357 SAN JOSE, CA 95109 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 7.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INS ADMIN | 721 SOUTH PARKER STREET SUITE 200 ORANGE, CA 92868 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $9K | 6.44% |
| CLIFFORD FRANKLIN BROOKS3 Filed as: CLIFFORD DER | 40485 ENCYCLOPEDIA CIRCLE C/O BENEFIT BROKERAGE SERVICES FREMONT, CA 94538 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 2.53% |
| JOHN VO3 | PO BOX 1357 SAN JOSE, CA 95109 | VISION SERVICE PLAN | $762 | — | $762 | 4.29% |
| CLIFFORD FRANKLIN BROOKS3 Filed as: CLIFFORD DER | 40485 ENCYCLOPEDIA CIRCLE FREMONT, CA 94538 | VISION SERVICE PLAN | $254 | — | $254 | 1.43% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 107 | $772K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $133K |
| Vision | VISION SERVICE PLAN | 114 | $18K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $133K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 107 | $772K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.