| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE & VASCONI INSURANCE | PO BOX 725 SAINT HELENA, CA 94574 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 2.16% |
| ALAN FONG INSURANCE SERVICES3 | 5858 HORTON STREET SUITE 350 EMERYVILLE, CA 94608 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 2.16% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE & VASCONI | PO BOX 725 SAINT HELENA, CA 94574 | WESTERN HEALTH ADVANTAGE | $5K | — | $5K | 2.99% |
| AFIS BENEFITS3 Filed as: AFIS BENEFITS & INSURANCE SVCS | 5858 HORTON STREET SUITE 350 EMERYVILLE, CA 94608 | WESTERN HEALTH ADVANTAGE | $4K | — | $4K | 2.50% |
| AFIS BENEFITS3 Filed as: AFIS BENEFITS & INSURANCE SVCS | 5858 HORTON STREET SUITE 350 EMERYVILLE, CA 94608 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 6.64% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE & VASCONI INSURANCE | PO BOX 640 NAPA, CA 94559 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 6.64% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 N. MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $503 | — | $503 | 2.92% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE & VASCONI | PO BOX 725 SAINT HELENA, CA 94574 | VISION SERVICE PLAN | $503 | — | $503 | 2.92% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE & VASCONI INSURANCE | PO BOX 725 SAINT HELENA, CA 94574 | PREMIER ACCESS INSURANCE COMPANY | $984 | — | $984 | 12.66% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 N. MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | PREMIER ACCESS INSURANCE COMPANY | $984 | — | $984 | 12.66% |
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 | 176 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 93 | $770K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 151 | $8K |
| Vision | VISION SERVICE PLAN | 149 | $17K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 190 | $23K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 190 | $23K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 93 | $770K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 190 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.