| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $30K | — | $30K | 3.57% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $35K | — | $35K | 5.00% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | $6K | $24K | 8.47% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | BLUE CROSS OF CALIFORNIA | $5K | — | $5K | 3.56% |
| HEFFERNAN INSURANCE BROKERS4 | 1350 CARLBACK AVENUE, SUITE 300 WALNUT CREEK, CA 94596 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 20.58% |
| INTERWEST INSURANCE SERVICES, LLC4 Filed as: INTERWEST INSURANCE SERVICES INC. | 8950 CAL CENTER DRIVE SACRAMENTO, CA 95826 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $239 | — | $239 | 2.16% |
| LISA L BASS4 | 1004 DAMERON ROAD BESSEMER CITY, NC 28016 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $92 | — | $92 | 0.83% |
| SOPHIE C POUTEAU4 | 1675 NOVATO BLVD, APT 11 NOVATO, CA 94947 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $25 | — | $25 | 0.23% |
| ALICE J HINDS4 | 109 COLD SPRINGS DRIVE GEORGETOWN, TX 78633 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $15 | — | $15 | 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 | 375 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 375 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 157 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 387 | $285K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 387 | $285K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 387 | $285K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 387 | $285K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 387 | $285K |
| Prescription drug(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 157 | $1.7M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 387 | $296K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.