| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVCO INSURANCE SERVICES INC3 Filed as: EVCO INSURANCE SERVICES, INC. | 1299 NEWELL HILL PLACE SUITE 301 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $29K | $10 | $29K | 4.12% |
| EVCO INSURANCE SERVICES INC3 | 1299 NEWELL HILL PLACE SUITE 301 WALNUT CREEK, CA 94596 | ANTHEM BLUE CROSS | $43K | — | $43K | 6.42% |
| AMWINS3 Filed as: LISI LLC | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS | — | $22K | $22K | 3.21% |
| EVCO INSURANCE SERVICES INC3 Filed as: EVCO INSURANCE SERVICES | — | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 5.00% |
| EVCO INSURANCE SERVICES INC3 | 1299 NEWELL HILL PLACE STE 301 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.94% |
| ANDREINI & COMPANY3 | STE 100 ONE MACARTHUR PL SANTA ANA, CA 92707 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$413 | — | -$413 | -1.01% |
| EVCO INSURANCE SERVICES INC3 Filed as: EVCO INSURANCE SERVICES, INC. | 1299 NEWELL HILL PL STE 301 WALNUT CREEK, CA 945965231 | VISION SERVICE PLAN | $1K | — | $1K | 5.06% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST #200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $341 | $5K | 19.81% |
| TSM INSURANCE & FINANCIAL SERVICES3 Filed as: TSM INS AND FINANCIAL | SERVICES INC 1317 OAKDALE RD STE 910 MODESTO, CA 95355 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.91% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST #200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $313 | $6K | 23.17% |
| TSM INSURANCE & FINANCIAL SERVICES3 Filed as: TSM INS AND FINANCIAL | SERVICES INC 1317 OAKDALE RD STE 910 MODESTO, CA 95355 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 9.38% |
| EVCO INSURANCE SERVICES INC3 | 1299 NEWELL HILL PLACE STE 301 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 16.36% |
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 | 135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 97 | $1.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 261 | $105K |
| Vision | VISION SERVICE PLAN | 125 | $25K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $82K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $41K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $41K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.