| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MINDSHARE BENEFITS & INSURANCE SERV3 | 127 SPRING ST STE 115 PLEASANTON, CA 94566 | BLUE SHIELD OF CALIFORNIA | $38K | $0 | $38K | 4.67% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 127 SPRING ST, STE 115 PLEASANTON, CA 94566 | KAISER FOUNDATION HEALTH PLAN, INC | $36K | $0 | $36K | 6.55% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 127 SPRING ST STE 115 PLEASANTON, CA 94566 | GUARDIAN | $18K | $0 | $18K | 11.01% |
| ENROLLEASE0 | 660 YORK STREET STE 102 SAN FRANCISCO, CA 94110 | GUARDIAN | $2K | $0 | $2K | 1.26% |
| MINDSHARE BENEFITS & INSURANCE SERV3 | 127 SPRING ST STE 115 PLEASANTON, CA 94566 | KAISER FOUNDATION HEALTH PLAN, INC | $5K | $0 | $5K | 4.57% |
| AMWINS0 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN, INC | $3K | $0 | $3K | 2.29% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 68 | $1.5M |
| Dental | GUARDIAN | 130 | $161K |
| Vision | GUARDIAN | 130 | $161K |
| Life insurance | GUARDIAN | 130 | $161K |
| Short-term disability | GUARDIAN | 130 | $161K |
| Long-term disability | GUARDIAN | 130 | $161K |
| Prescription drug(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 68 | $1.5M |
| Other | GUARDIAN | 130 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.