| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAURA AFOA INSURANCE SERVICES, LLC3 | 1777 BOREL PLACE, SUIT 511 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | $165K | $0 | $165K | 6.20% |
| CLAREMONG BUSINESS GROUP3 | 1000 BURNETT AVENUE, SUITE 440 CONCORD, CA 94520 | CALIFORNIA PHYSICIANS SERVICE | $63K | $0 | $63K | 2.38% |
| LAURA AFOA INSURANCE SERVICES, LLC | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | DELTA DENTAL OF CALIFORNIA | $34K | $0 | $34K | 10.00% |
| BEERE & PURVES INC3 Filed as: BEERE AND PURVES, INC. | 1350 TREAT BOULEVARD, SUITE 470 WALNUT CREEK, CA 94597 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 5.00% |
| LAURA AFOA INSURANCE SERVICES, LLC3 | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $0 | $14K | 4.89% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAURA AFOA INSURNCE SERVICES, LLC | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 5.03% |
| AMWINS3 Filed as: LISI, INC. | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 2.50% |
| INTERNATIONAL EMPLOYEE BENEFIT SOLU3 Filed as: INTERNATIONAL EMPLOYEE BENEFIT SOL. | 160 GUTHRIE LAND, SUITE 22 BRENTWOOD, CA 94513 | ACE AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 20.00% |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 453 | $2.8M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 550 | $634K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $296K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $296K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $296K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $296K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 453 | $2.8M |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $301K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 550 | — |
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.