| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED HEALTHCARE INSURANCE COMPANY | $86K | $6K | $91K | 3.74% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 2.97% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | SELECTHEALTH | $3K | — | $3K | 3.58% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CT 94596 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $606 | $8K | 14.28% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP INC | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NC 89081 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $461 | — | $461 | 11.42% |
| DINO J. CICCONE4 Filed as: DINO J CICCONE | 16889 CARMICHAEL AVENUE CALDWELL, ID 73607 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $240 | — | $240 | 5.95% |
| VARIOUS - SEE ATTACHMENT3 | C/O COLONIAL - PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | — | $128 | 6.69% |
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 | 196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 345 | $2.6M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 345 | $2.4M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 345 | $2.4M |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $60K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $60K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $60K |
| Prescription drug(2 contracts) | UNITED HEALTHCARE INSURANCE COMPANY | 345 | $2.5M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 345 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.