| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASSIDY O'HARA3 | 1123 CHERRY AVENUE SAN JOSE, CA 95125 | KAISER FOUNDATION HEALTH PLAN | $42K | — | $42K | 3.28% |
| RSC INSURANCE BROKERAGE INC3 | 700 AIRPORT BOULAVARD SUITE 300 BURLINGAME, CA 94010 | KAISER FOUNDATION HEALTH PLAN | $22K | — | $22K | 1.71% |
| ALLIED BENEFIT SYSTEMS, LLC Filed as: ALLIED BENEFIT SYSTEMS INC | — | NATIONAL UNION FIRE | — | — | $0 | 0.00% |
| CASSIDY O'HARA3 | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 6.67% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.33% |
| AGIS NETWORK INC3 | 2122 KRATKY ROAD SAINT LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.00% |
| CASSIDY O'HARA3 Filed as: CASSIDY E O'HARA | 738 NORTH FIRST STREET SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 6.75% |
| RSC INSURANCE BROKERAGE INC3 | 1400 ROCKY RIDGE DRIVE SUITE 280 ROSEVILLE, CA 95661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.25% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY SUITE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $420 | $420 | 0.81% |
| CASSIDY O'HARA3 Filed as: CASSIDY O' HARA | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.68% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.32% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 NORTH 1ST STREET SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $2K | — | $2K | 6.59% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET FLOOR 2 BOSTON, MA 02110 | VISION SERVICE PLAN | $770 | — | $770 | 2.49% |
| AGIS NETWORK INC3 | 2122 KRATKY ROAD SAINT LOUIS, MA 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 9.92% |
| CASSIDY O'HARA3 Filed as: CASSIDY E O'HARA | 738 NORTH FIRST STREET SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $818 | — | $818 | 5.78% |
| RSC INSURANCE BROKERAGE INC3 | 1400 ROCKY RIDGE DRIVE SUITE 280 ROSEVILLE, CA 95661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $585 | — | $585 | 4.13% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY SUITE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $146 | $146 | 1.03% |
| FILICE INSURANCE AGENCY3 | 738 NORTH 1ST STREET SUITE 202 SAN JOSE, CO 95112 | CLAREMONT EAP | $415 | — | $415 | 3.24% |
| RISK STRATEGIES COMPANY3 | 2270 DOUGLAS BOULEVARD SUITE 220 ROSEVILLE, CA 95661 | CLAREMONT EAP | $224 | — | $224 | 1.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RSC INSURANCE BROKERAGE EIN 16-1689464 BROKER | Insurance agents and brokers Service code 22 | — | $82K |
| DIRECT DENTAL ADMINISTRATORS, LLC CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 7510 SHORELINE DRIVE STOCKTON, CA 95219 | $26K |
| ALLIED BENEFIT SYSTEMS INC EIN 36-3086057 TPA | Claims processing Service code 12 | — | $21K |
| CIGNA EIN 59-1031071 SERVICE PROVIDER | Insurance services Service code 23 | — | $15K |
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 | 229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN | 237 | $1.3M |
| Vision | VISION SERVICE PLAN | 208 | $31K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 228 | $70K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 225 | $49K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | NATIONAL UNION FIRE | 82 | $567K |
| Other(5 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 228 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.