| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MALLOY IMRIE & VASCONI INS. SVS.3 Filed as: MALLOY IMRIE & VASCONI INS. SVCS. | PO BOX 725 SAINT HELENA, CA 94574 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $0 | $14K | 2.18% |
| UBF INSURANCE SERVICES, INC.3 | 2033 NORTH MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $0 | $14K | 2.18% |
| MALLORY IMRIE & VASCONI INS. SVCS.3 | 899 ADAMS STREET SUITE C SAINT HELENA, CA 94574 | SUTTER HEALTH PLAN | $6K | $0 | $6K | 2.50% |
| UBF INSURANCE SERVICES, INC.3 | 2033 NORTH MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | SUTTER HEALTH PLAN | $6K | $0 | $6K | 2.50% |
| UBF INSURANCE SERVICES, INC.3 | 2033 NORTH MAIN ST WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $467 | $0 | $467 | 3.09% |
| UBF INSURANCE SERVICES, INC.3 | 2033 NORTH MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | METROPOLITAN LIFE INSURANCE COMPANY | $402 | $0 | $402 | 4.64% |
| UBF INSURANCE SERVICES, INC.3 | 2033 NORTH MAIN ST SUITE 700 WALNUT CREEK, CA 94596 | PREMIER ACCESS INSURANCE COMPANY | $1K | $0 | $1K | 16.15% |
| MALLORY IMRIE & VASCONI INS. SVCS.3 Filed as: MALLORY IMRIE & VASCONI INS SVCS | PO BOX 725 SAINT HELENA, CA 94574 | PREMIER ACCESS INSURANCE COMPANY | $1K | $0 | $1K | 16.15% |
| MALLORY IMRIE & VASCONI INS. SVCS.3 | PO BOX 640 NAPA, CA 94559 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $414 | $0 | $414 | 5.50% |
| UBF INSURANCE SERVICES, INC.3 | 2033 NORTH MAIN ST WALNUT CREEK, CA 94596 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $414 | $0 | $414 | 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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 77 | $895K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 233 | $8K |
| Vision | VISION SERVICE PLAN | 116 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 153 | $8K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 130 | $9K |
| Prescription drug | SUTTER HEALTH PLAN | 25 | $232K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 153 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.