| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | BLUE SHIELD OF CALIFORNIA | $0 | $778K | $778K | 4.73% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 1233 ALPINE ROAD STE 201 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $229K | — | $229K | 1.75% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 1233 ALPINE ROAD WALNUT CREEK, CA 94596 | DELTA DENTAL OF CALIFORNIA | $86K | — | $86K | 3.00% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 1233 ALPINE ROAD STE 201 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | — | $11K | 1.53% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 1233 ALPINE ROAD STE. 200 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $23K | — | $23K | 5.41% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 6200 CANOGA AVE. STE. 325 WOODLAND HILLS, CA 91367 | THE UNION LABOR LIFE INSURANCE CO. | $21K | — | $21K | 10.00% |
| R.L. MILSNER INC.3 Filed as: R.L. MILSNER AND CO | 1233 ALPINE ROAD WALNUT CREEK, CA 94596 | GUARDIAN LIFE INSURANCE CO OF AMERICA | $993 | — | $993 | 14.21% |
| WILLNER-CARDINET-KIDWELL3 | 333 N INDIAN HILL BLVD CLAREMONT, CA 91711 | GUARDIAN LIFE INSURANCE CO OF AMERICA | $20 | — | $20 | 0.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARIA RIVERA EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $82K |
| LAW FIRM OF JAMES P. BAKER EIN 87-3996649 NONE | Legal; Direct payment from the plan Service code 29 | — | $70K |
| NICOLE ESOCBAR EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $54K |
| STEPHANIE GUERRA EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $53K |
| TINA FAN EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $45K |
| SEGAL BRYANT & HAMILL, LLC EIN 35-2679129 NONE | Investment management; Direct payment from the plan Service code 28 | — | $43K |
| WILLIAM OLINGER EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $42K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $38K |
| KATIE RAVETTI EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $37K |
| JILLIAN BAIRES EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $37K |
| STEFNI ADVINCULA EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | 1621 MARKET STREET, SUITE 400 SAN FRANCISCO, CA 94103 | $31K |
| RAEL & LETSON EIN 94-1701048 NONE | Consulting (general); Accounting (including auditing) Service code 10 | — | $23K |
| MORGAN STANLEY EIN 20-8764829 NONE | Direct payment from the plan; Securities brokerage; Other investment fees and expenses; Other services; Securities brokerage commissions and fees; Investment advisory (plan); Other commissions Service code 27 | — | $21K |
| RL MILSNER EIN 94-2494656 NONE | Insurance brokerage commissions and fees Service code 53 | — | $18K |
| PRO PRINT EIN 94-3160648 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $10K |
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 | 1,184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 214 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 1,872 | $30.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,338 | $2.9M |
| Vision | VISION SERVICE PLAN | 1,330 | $419K |
| Life insurance(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE CO. | 1,338 | $217K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 1,872 | $16.5M |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE CO. | 1,338 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,872 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.