| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AVERY GROUP INSURANCE SOLUTIONS INC3 | 37600 CENTRAL CT., STE. #211 NEWARK, CA 94560 | CALIFORNIA PHYSICIANS' SERVICE | — | $122K | $122K | 5.82% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN, INSURANCE | ADMINISTRATORS, INC 701 S PARKER ST 8TH FL ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | $44K | — | $44K | 2.12% |
| AVERY GROUP INSURANCE SOLUTIONS INC3 | 37600 CENTRAL CT., STE. #211 NEWARK, CA 94560 | CALIFORNIA PHYSICIANS' SERVICE | — | $69 | $69 | 0.00% |
| EMERSON REID LLC3 | 1787 SENTRY PKWY W VEVA 16 SUITE 320 BLUE BELL, PA 19422 | GUARDIAN | $60K | $10K | $69K | 16.81% |
| IAN LENG HOI3 | 37600 CENTRAL CT STE 211 NEWARK, CA 945603456 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | — | $10K | 4.86% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN, INSURANCE | ADMINISTRATORS, INC. 721 S PARKER ST STE 300 ORANGE, CA 928684732 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 1.55% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INSURANCE | SERVICES, LLC 1850 GATEWAY DR STE 700 SAN MATEO, CA 944044067 | KAISER FOUNDATION HEALTH PLAN, INC. | — | $1 | $1 | 0.00% |
| IAN LENG HOI3 | 37600 CENTRAL CT STE 211 NEWARK, CA 945603456 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 5.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS, INC. 721 S PARKER ST STE 300 ORANGE, CA 928684732 | KAISER FOUNDATION HEALTH PLAN, INC. | $597 | — | $597 | 1.80% |
| AVERY GROUP INSURANCE SOLUTIONS INC3 | 37600 CENTRAL CT SUITE 211 NEWARK, CA 94560 | NATIONAL UNION FIRE INS. CO. OF PITTSBUGH, PA | $258 | — | $258 | 15.02% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 283 | $2.3M |
| Dental | GUARDIAN | 170 | $412K |
| Vision | GUARDIAN | 170 | $412K |
| Life insurance | GUARDIAN | 170 | $412K |
| Short-term disability | GUARDIAN | 170 | $412K |
| Long-term disability | GUARDIAN | 170 | $412K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 283 | $2.1M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 181 | $413K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.