| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE AND VASCONI INS SVCS | PO BOX 725 SAINT HELENA, CA 94574 | KAISER FOUNDATION HEALTH PLAN INC | $15K | $0 | $15K | 2.15% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 1.78% |
| ALAN FONG INSURANCE SERVICES3 Filed as: ALAN FONG INSURANCE SERVICES INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 0.36% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES, INC | 2033 NORTH MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | WESTERN HEALTH ADVANTAGE | $3K | $0 | $3K | 2.50% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE AND VASCONI INS SVCS | 899 ADAMS STREET, SUITE C SAINT HELENA, CA 94574 | WESTERN HEALTH ADVANTAGE | $3K | $0 | $3K | 2.50% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES, INC | 2033 NORTH MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $499 | $0 | $499 | 2.95% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE AND VASCONI | PO BOX 725 SAINT HELENA, CA 94574 | VISION SERVICE PLAN | $499 | $0 | $499 | 2.95% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 NORTH MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | METROPOLITAN LIFE INSURANCE COMPANY | $444 | $0 | $444 | 4.61% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE AND VASCONI INS SVCS | PO BOX 725 SAINT HELENA, CA 94574 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 17.36% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 NORTH MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | PREMIER ACCESS INSURANCE COMPANY | $2K | $0 | $2K | 17.36% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES, INC | 2033 NORTH MAIN STREET SUITE 700 WALNUT CREEK, CA 94596 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $495 | $0 | $495 | 5.50% |
| MALLOY IMRIE & VASCONI INS. SVCS3 Filed as: MALLOY IMRIE AND VASCONI INS SVCS | PO BOX 640 NAPA, CA 94559 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $495 | $0 | $495 | 5.50% |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 98 | $820K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 254 | $9K |
| Vision | VISION SERVICE PLAN | 142 | $17K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 177 | $9K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 171 | $10K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 98 | $820K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 177 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.