| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $131K | $0 | $131K | 3.26% |
| PORTAL INSURANCE AGENCY, INC.3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | HEALTHNET | $59K | $0 | $59K | 3.47% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 650 WALNUT CREEK, CA 94597 | DELTA DENTAL OF CALIFORNIA | $14K | $0 | $14K | 2.99% |
| PORTAL INSURANCE AGENCY, INC.3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | DELTA DENTAL OF CALIFORNIA | $57 | $0 | $57 | 0.01% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 650 WALNUT CREEK, CA 94597 | STANDARD INSURANCE COMPANY | $9K | $1K | $10K | 5.74% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 7.21% |
| PORTAL INSURANCE AGENCY, INC.3 | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 3.68% |
| MJ INSURANCE3 Filed as: SALVADOR HEREDIA AND VARIOUS AGENTS | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $612 | $203 | $815 | 2.66% |
| PORTAL INSURANCE AGENCY, INC.3 | 1277 TREAT BOULEVARD WALNUT CREEK, CA 94597 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $554 | $0 | $554 | 1.81% |
| BRIAN ROBERT LLOYD3 | PO BOX 11 KNIGHTSEN, CA 94548 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $178 | $286 | $464 | 1.51% |
| WAYNE RIMMER3 Filed as: WAYNE P. SMITH | 1113 WEST GROVE WAY COEUR DALENE, ID 83815 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $347 | $0 | $347 | 1.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD LAFAYETTE, CA 94549 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $336 | $0 | $336 | 1.09% |
| CANDICE ELISE EUSEBIO3 | 5756 OWENS DRIVE, SUITE 205 PLEASANTON, CA 94588 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $271 | $29 | $300 | 0.98% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN & ASSOCIATES, INC. | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $226 | $0 | $226 | 0.74% |
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 | 428 | 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) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 593 | $5.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 845 | $474K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 769 | $37K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 428 | $203K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 35 | $31K |
| Long-term disability | STANDARD INSURANCE COMPANY | 428 | $172K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 593 | $5.7M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 437 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 845 | — |
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.