| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLAN WISER INSURANCE SERVICES INC3 | 4809 SPARKS AVE SAN DIEGO, CA 92110 | KAISER FOUNDATION HEALTH PLANS INC | $25K | — | $25K | 2.99% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ALLAN WISER INSURANCE SERVIES | 4809 SPARKS AVE SAN DIEGO, CA 92110 | BLUE SHIELD OF CALIFORNIA | $22K | — | $22K | 3.00% |
| ALLAN WISER INSURANCE SERVICES INC3 | 4809 SPARKS AVE SAN DIEGO, CA 92110 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $10K | — | $10K | 2.71% |
| ALLAN WISER INSURANCE SERVICES INC3 | 4809 SPARKS AVE SAN DIEGO, CA 92110 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 2.56% |
| ALLAN WISER INSURANCE SERVICES INC Filed as: ALLAN MARK WISER | 4809 SPARKS AVE SAN DIEGO, CA 92110 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 0.45% |
| ALLAN WISER INSURANCE SERVICES INC3 Filed as: ALLAN WISER INSURANCE SERVICES | 4809 SPARKS AVE SAN DIEGO, CA 92110 | GROUP HEALTH COOPERATIVE | $1K | — | $1K | 2.29% |
| ROBERT E PONCINI4 Filed as: ROBERT W HEITMAN | 2130 HIGH ST ATWATER, CA 95301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $623 | — | $623 | 2.52% |
| SALSBURY & ASSOCIATES INS SVCS INC3 | 3155 KEARNEY ST STE 240 FREMONT, CA 94538 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $610 | — | $610 | 2.47% |
| LISA M KELLEY4 | 2019 LUGANO CT MANTECA, CA 95337 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $313 | — | $313 | 1.27% |
| WAYNE RIMMER4 Filed as: WAYNE P SMITH | 1113 WEST GROVE WAY COEUR DALENE, ID 83815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $164 | — | $164 | 0.66% |
| WILLIAM WAYNE STIGILE4 Filed as: WILLIAM W STIGILE | 514 GRINDSTONE WOODBRIDGE, CA 95258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | — | $128 | 0.52% |
| SCOTT E BOORE4 | 8 STONEHAVEN CT NOVATO, CA 94947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.21% |
| WHITFIELD BENEFIT SOLUTIONS4 | 341 W TUDOR RD ANCHORAGE, AK 99503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.13% |
| G SCOTT COOKE4 Filed as: SCOTT ALLEN BEER | 829 CYNTHIA DRIVE WATSONVILLE, CA 95076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.10% |
| STEPHEN D PACE4 | 1016 GOLDENROD DR NAMPA, ID 83686 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.06% |
| HOLLERN & ASSOCIATES INCORPORATED4 | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| CHEYRL D SMITH4 | 14442 BORA DRIVE LA MIRANDA, CA 90638 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| ALLAN WISER INSURANCE SERVICES INC3 | 4809 SPARKS AVE SAN DIEGO, CA 92110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ALLAN WISER INSURANCE SERVICES INC3 Filed as: ALLAN MARK WISER | 4809 SPARKS AVE SAN DIEGO, CA 92110 | VISION SERVICE PLAN | $588 | — | $588 | 3.00% |
| ALLAN WISER INSURANCE SERVICES INC3 | 4809 SPARKS AVE SAN DIEGO, CA 92110 | MANAGED HEALTH NETWORK | $189 | — | $189 | 5.01% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 135 | $2.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 357 | $248K |
| Vision | VISION SERVICE PLAN | 127 | $20K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 357 | $272K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 357 | $248K |
| Prescription drug(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 92 | $1.1M |
| Other | MANAGED HEALTH NETWORK | 141 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.