| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC. | PO BOX 255188 SACRAMENTO, CA 95865 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | — | $32K | 4.09% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.85% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC. | PO BOX 255118 SACRAMENTO, CA 95865 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $10K | — | $10K | 3.25% |
| JAMES A. BULOTTI3 Filed as: JAMES A BULOTTI | 3636 AMERICAN RIVER DRIVE, 2ND FL SACRAMENTO, CA 95864 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 5.56% |
| HEFFERNAN INSURANCE BROKERS3 | 350 CARLBACK AVENUE WALNUT CREEK, CA 94596 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $676 | — | $676 | 0.43% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC. | PO BOX 255118 SACRAMENTO, CA 95865 | BLUE CROSS OF CALIFORNIA | $2K | — | $2K | 3.25% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC. | 3636 AMERICAN RIVER DRIVE, 2ND FL SACRAMENTO, CA 95864 | UNION SECURITY INSURANCE COMPANY | $3K | — | $3K | 11.96% |
| HEFFERNAN INSURANCE BROKERS3 | 350 CARLBACK AVENUE WALNUT CREEK, CA 94596 | UNION SECURITY INSURANCE COMPANY | $894 | — | $894 | 4.22% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES INC. | 3636 AMERICAN RIVER DRIVE, 2ND FL SACRAMENTO, CA 95864 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 19.81% |
| HEFFERNAN INSURANCE BROKERS3 | 350 CARLBACK AVENUE, SUITE 300 WALNUT CREEK, CA 94596 | UNION SECURITY INSURANCE COMPANY | $793 | — | $793 | 8.56% |
| INTERWEST INSURANCE SERVICES, LLC4 Filed as: INTERWEST INSURANCE SERVICES INC. | 3636 AMERICAN RIVER DRIVE, 2ND FL SACRAMENTO, CA 95864 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 31.60% |
| LISA L BASS4 | 1152 RANCH POINT WAY ANTIOCH, CA 94531 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $171 | — | $171 | 2.68% |
| SOPHIE C POUTEAU4 | 1675 NOVATO BLVD, APT 11 NOVATO, CA 94947 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $25 | — | $25 | 0.39% |
| ALICE J HINDS4 | 2175 RANCHO WAY PITTSBURGH, CA 94565 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $16 | — | $16 | 0.25% |
| HEFFERNAN INSURANCE BROKERS4 | 1350 CARLBACK AVENUE, SUITE 300 WALNUT CREEK, CA 94596 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $9 | — | $9 | 0.14% |
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 | 295 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 157 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 344 | $156K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 344 | $156K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 350 | $21K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 344 | $156K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 344 | $156K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 157 | $1.2M |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 51 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
No prospect flags tripped on this filing.