| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DH INSURANCE SERVICES3 Filed as: D H INSURANCE SERVICES | 2727 WALSH AVENUE SANTA CLARA, CA 95051 | BLUE CROSS OF CALIFORNIA | $49K | — | $49K | 3.60% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES INC. | 500 YGNACIO VALLEY ROAD WALNUT CREEK, CA 94596 | BLUE CROSS OF CALIFORNIA | — | $25K | $25K | 1.82% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 0.94% |
| DH INSURANCE SERVICES3 Filed as: D H INSURANCE SERVICES | — | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 3.42% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 1.08% |
| DH INSURANCE SERVICES3 Filed as: D H INSURANCE SERVICES | 2727 WALSH AVENUE SANTA CLARA, CA 95051 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 6.48% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 3.52% |
| DH INSURANCE SERVICES3 Filed as: D H INSURANCE SERVICES | 2727 WALSH AVENUE SANTA CLARA, CA 95051 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 5.01% |
| DH INSURANCE SERVICES3 Filed as: D H INSURANCE SERVICES | 2727 WALSH AVENUE SANTA CLARA, CA 95051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.55% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $151 | $2K | 6.30% |
| DH INSURANCE SERVICES3 Filed as: D H INSURANCE SERVICES | 2727 WALSH AVENUE SANTA CLARA, CA 95051 | VISION SERVICE PLAN | $1K | — | $1K | 3.78% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $676 | — | $676 | 2.10% |
| ENROLLEASE3 | 1980 FESTIVAL PLAZA DRIVE LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $273 | — | $273 | 0.85% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 114 | $1.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 151 | $139K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 135 | $1.4M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $37K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $37K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $37K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 114 | $1.7M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $37K |
| 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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.