| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | HEALTHNET | $52K | $0 | $52K | 3.50% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $60K | $0 | $60K | 4.50% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 0.89% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | DELTA DENTAL OF CALIFORNIA | $13K | $0 | $13K | 3.00% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | STANDARD INSURANCE COMPANY | $8K | $3K | $11K | 6.99% |
| MJ INSURANCE3 Filed as: WAYNE SMITH AND VARIOUS AGENTS | 402 WEST LOCKHART LANE MERIDIAN, ID 83646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $904 | $184 | $1K | 2.70% |
| BRITTANY LLOYD3 | PO BOX 4942 EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $678 | $330 | $1K | 2.50% |
| RELATION INSURANCE SERVICES OF CA3 | 1277 TREAT BOULEVARD SUITE 400 WALNUT CREEK, CA 94597 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $905 | $16 | $921 | 2.29% |
| PAMELA KAY LONG3 Filed as: PAMELA LONG | 200 SOUTH LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $334 | $78 | $412 | 1.02% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $332 | $0 | $332 | 0.82% |
| STEPHANIE NOELLE KUGLER3 Filed as: STEPHANIE KUGLER | 21068 VALLEY CIRCLE ELKHORN, NE 68022 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $248 | $62 | $310 | 0.77% |
| BRIAN ROBERT LLOYD3 Filed as: BRIAN LLOYD | 3053 COPPERWOOD WAY EL DORADO HILLS, CA 95762 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $139 | $148 | $287 | 0.71% |
| 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. | $4K | $0 | $4K | 10.79% |
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 | 412 | 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) | 417 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | HEALTHNET | 420 | $4.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 717 | $441K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 654 | $35K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 412 | $191K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 36 | $40K |
| Long-term disability | STANDARD INSURANCE COMPANY | 412 | $150K |
| Prescription drug(3 contracts, 2 carriers) | HEALTHNET | 420 | $4.1M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 412 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 717 | — |
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.