| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | KAISER FOUNDATION HEALTH PLAN, INC. | $109K | $0 | $109K | 1.66% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | HEALTH NET | $53K | $0 | $53K | 3.33% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 2300 CONTRA COSTA BOULEVARD SUITE 525 PLEASANT HILL, CA 94523 | DELTA DENTAL OF CALIFORNIA | $12K | $0 | $12K | 3.00% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 5.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $105 | $105 | 0.07% |
| BRITTANY LLOYD3 | 6234 KINGS PEAK DRIVE EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 5.24% |
| J&H FIN. & INS. SVCS, LLC & OTHERS3 | 22948 VIA CEREZA UNIT 4E MISSION VIEJO, CA 92691 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $142 | $3K | 3.43% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.32% |
| BRIAN ROBERT LLOYD3 | 6234 KINGS PEAK DRIVE EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $583 | $1K | $2K | 2.23% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $227 | $2K | 2.09% |
| CASEY JAMES KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $184 | $1K | $2K | 2.02% |
| STEPHANIE NOELLE KUGLER3 | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $908 | $295 | $1K | 1.48% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $4K | $0 | $4K | 9.76% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | PO BOX 516624 LOS ANGELES, CA 90051 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $4K | — | $4K | 9.76% |
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 | 484 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 527 | $8.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 743 | $408K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 669 | $36K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 484 | $234K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 48 | $81K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 484 | $153K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 527 | $8.2M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 484 | $252K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 743 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.