| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAURA AFOA INSURANCE SERVICES, LLC3 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | $0 | $285K | $285K | 5.25% |
| CLAREMONT BUSINESS GROUP3 | 1000 BURNETT AVENUE, SUITE 440 CONCORD, CA 94520 | CALIFORNIA PHYSICIANS SERVICE | $114K | $0 | $114K | 2.10% |
| LAURA AFOA INSURANCE SERVICES, LLC3 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | DELTA DENTAL OF CALIFORNIA | $32K | $0 | $32K | 5.22% |
| LAURA AFOA INSURANCE SERVICES, LLC3 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC | $27K | $0 | $27K | 4.81% |
| AMWINS3 Filed as: LISI, INC. | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 2.31% |
| LAURA AFOA INSURANCE SERVICES, LLC3 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 2.95% |
| LAURA AFOA INSURANCE SERVICES, LLC3 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.89% |
| LAURA AFOA INSURANCE SERVICES, LLC3 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.00% |
| MASOLI LEGACY LLC4 Filed as: MASOLI LEGACY, LLC | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $451 | $0 | $451 | 2.18% |
| LAURA AFOA INSURANCE SERVICES, LLC4 Filed as: LAURA AFOA INSURANCE SERVICES | 1777 BOREL PLACE, SUITE 511 SAN MATEO, CA 94402 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $342 | $0 | $342 | 1.65% |
| DAURENE LEE LLC4 Filed as: DAURENE LEE, LLC | 2505 ANTHEM VILLAGE DRIVE EAST SUITE 589 HENDERSON, NV 89052 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $342 | $0 | $342 | 1.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11933 NORTH CATAMARAN WAY STAR, ID 83669 | ACE AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 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 | 362 | 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) | 362 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 722 | $6.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 811 | $618K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 358 | $63K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 370 | $335K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 370 | $335K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 370 | $335K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 722 | $6.0M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 370 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 811 | — |
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.