| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GEORGE PETERSEN INSURANCE3 | 175 COLLEGE AVE. SANTA ROSA, CA 95401 | KAISER FOUNDATION HEALTH PLAN INC. | $80K | $43 | $80K | 3.62% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 NORTH MAIN STREET WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC. | $29K | — | $29K | 1.33% |
| GEORGE PETERSEN INSURANCE3 | 175 COLLEGE AVE. SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $359 | $5K | 5.10% |
| MINTO & WILKIE INSURANCE3 | P.O BOX 3539 SANTA ROSA, CA 95402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.87% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 NORTH MAIN STREET WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $611 | — | $611 | 0.59% |
| GEORGE PETERSEN INSURANCE3 | 175 COLLEGE AVE. SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 9.94% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 NORTH MAIN STREET WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $786 | — | $786 | 6.41% |
| MINTO & WILKIE INSURANCE3 | P.O BOX 3539 SANTA ROSA, CA 95402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $670 | — | $670 | 5.47% |
| GEORGE PETERSEN INSURANCE3 | 175 COLLEGE AVE. SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $609 | $31 | $640 | 7.10% |
| MINTO & WILKIE INSURANCE3 | P.O BOX 3539 SANTA ROSA, CA 95402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $531 | — | $531 | 5.89% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 NORTH MAIN STREET WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $317 | — | $317 | 3.52% |
| GEORGE PETERSEN INSURANCE3 | 175 COLLEGE AVE. SANTA ROSA, CA 95401 | CALIFORNIA PHYSICIANS SERVICE | $232 | — | $232 | 7.40% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES | 2033 NORTH MAIN STREET WALNUT CREEK, CA 94596 | CALIFORNIA PHYSICIANS SERVICE | $81 | — | $81 | 2.58% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 272 | $2.2M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 16 | $3K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 157 | $112K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 157 | $103K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 272 | $2.2M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 157 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.