| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 2 PARK PLAZA SUITE 440 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | $67K | — | $67K | 4.72% |
| GUSTO INSURANCE SVCS LLC3 | 525 20TH ST SAN FRANCISCO, CA 94107 | CALIFORNIA PHYSICIANS SERVICE | $4K | — | $4K | 0.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN | 2321 ROSECRANS AVE SUITE 2240 EL SEGUNDO, CA 90245 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $11K | — | $11K | 7.87% |
| GUSTO INSURANCE SVCS LLC3 | 500 3RD STREET SUITE 405 SAN FRANCISCO, CA 94107 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 0.82% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 6711 COLUMBIA GATEWAY DR COLUMBIA, MD 21046 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 4.45% |
| ZP INSURANCE LLC3 | 525 20TH ST SAN FRANCISCO, CA 94107 | KAISER FOUNDATION HEALTH PLAN INC | $462 | — | $462 | 0.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 2 PARK PLAZA SUITE 440 IRVINE, CA 92614 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE CO. | $1K | — | $1K | 9.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. INC. | 701 S PARKER ST 8TH FLOOR ORANGE, CA 92868 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE CO. | $310 | — | $310 | 2.00% |
| GUSTO INSURANCE SVCS LLC3 | 525 20TH ST SAN FRANCISCO, CA 94107 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE CO. | $103 | — | $103 | 0.67% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 218 | $1.6M |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 280 | $135K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 280 | $135K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE CO. | 199 | $15K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 218 | $1.6M |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE CO. | 199 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.