| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 700 AIRPORT BOULEVARD SUITE 300 BURLINGAME, CA 94010 | KAISER FOUNDATION HEALTH PLAN INC | $67K | — | $67K | 4.99% |
| AGIS NETWORK INC3 | 2122 KRATKY ROAD ST LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 8.95% |
| RSC INSURANCE BROKERAGE INC3 | 1400 ROCKY RIDGE DRIVE SUITE 280 ROSEVILLE, CA 95661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 8.95% |
| EMERSON REID LLC3 | 1787 SENTRY PARKWAY SUITE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.24% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| EMERSON REID LLC3 | 350 5TH AVENUE # 3700 NEW YORK, NY 10118 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 9.98% |
| EMERSON REID LLC3 | 350 5TH AVENUE # 3700 NEW YORK, NY 10118 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 10.09% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET FLOOR 2 BOSTON, MA 02110 | VISION SERVICE PLAN | $2K | — | $2K | 4.18% |
| RICHARD B MILLANG INS SVCS INC3 | 8 CUTTER DRIVE WATSONVILLE, CA 95076 | AFLAC | $4K | $154 | $4K | 10.18% |
| AMY E COHEN3 Filed as: AMY A PURVIS | 90 GREAT OAKS BOULEVARD SUITE 103 SAN JOSE, CA 95119 | AFLAC | $1K | $31 | $1K | 3.05% |
| DERREK LYN KECK3 | 17809 COUNTRYSIDE COURT SALINAS, CA 93907 | AFLAC | $656 | $31 | $687 | 1.91% |
| ERNESTO T GONZALEZ3 | 22720 CANYON VIEW DRIVE CORONA, CA 92883 | AFLAC | $148 | — | $148 | 0.41% |
| D BREDESON INSURANCE SERVICES INC3 | 19043 META ROAD CORNELIUS, NC 28031 | AFLAC | $64 | — | $64 | 0.18% |
| ERNESTO T GONZALEZ3 | 10653 WEST LEILANI DRIVE BOISE, ID 83709 | AFLAC | $62 | — | $62 | 0.17% |
| BARBARA AMY PHILLIPS3 | 648 VIA CIELITO VENTURA, CA 93003 | AFLAC | $58 | — | $58 | 0.16% |
| JOSEPH LEONARD HERRERA3 | 2725 AVENIDA CORAZON SOUTHEAST RIO RANCHO, NM 87124 | AFLAC | $38 | — | $38 | 0.11% |
| WILLIAM V SCHAUB3 | 28 NORTH 1ST STREET SUITE 700 SAN JOSE, CA 95113 | AFLAC | $33 | — | $33 | 0.09% |
| DAN R ELLIS3 | 3767 NORTH PLAYER DRIVE COEUR D ALENE, ID 83815 | AFLAC | $27 | — | $27 | 0.07% |
| WILLIAM V SCHAUB3 | 81 VINTAGE CIRCLE UNIT 3247 PLEASANTON, CA 94566 | AFLAC | $20 | — | $20 | 0.06% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS ROAD ROSEVILLE, CA 95678 | AFLAC | $14 | — | $14 | 0.04% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 641 HIGUERA STREET SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $13 | — | $13 | 0.04% |
| DOUGLAS MARTIN BELSER3 | 4337 EAST GRAND RIVER AVENUE SUITE 136 HOWELL, MI 48843 | AFLAC | $12 | — | $12 | 0.03% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 728 MERCER PLACE HUNTERSVILLE, NC 28078 | AFLAC | $9 | — | $9 | 0.02% |
| SHANE M OWEN3 Filed as: SHANE CRAIG DAVISON | 120 PROVIDENCE TRAIL APARTMENT 1200 MT JULIET, TN 37122 | AFLAC | $5 | — | $5 | 0.01% |
| CHARLES D. BLOCK3 Filed as: CHARLES B CAREY | 16165 LYLE STREET SAN LEANDRO, CA 94578 | AFLAC | $5 | — | $5 | 0.01% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 9300 HARRIS CORNERS PARKWAY SUITE 100 CHARLOTTE, NC 28269 | AFLAC | $4 | — | $4 | 0.01% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER LYMAN SR | 8A SOUTH VOLUNTARIO STREET SANTA BARBARA, CA 93103 | AFLAC | $3 | — | $3 | 0.01% |
| JEANETTE SCHAUB3 | 28 NORTH 1ST STREET SUITE 700 SAN JOSE, CA 95113 | AFLAC | $2 | — | $2 | 0.01% |
| REGINA E MARTINELLI3 | 3360 RIVER ROAD WINDSOR, CA 95492 | AFLAC | $2 | — | $2 | 0.01% |
| JEANETTE SCHAUB3 | 81 VINTAGE CIRCLE UNIT 3247 PLEASANTON, CA 94566 | AFLAC | $1 | — | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $1 | — | $1 | 0.00% |
| CHARLES D. BLOCK3 Filed as: CHARLES B CAREY | 16215 LYLE STREET SAN LEANDRO, CA 94578 | AFLAC | $1 | — | $1 | 0.00% |
| MARIAN A LOPEZ3 | 13322 CITICOURT LANE WHITTIER, CA 90602 | AFLAC | $1 | — | $1 | 0.00% |
| KAI DEERING3 | 699 BORREGAS AVENUE SUNNYVALE, CA 94085 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $931 | — | $931 | 12.98% |
| JAMES M HICKS3 | 4243 AVON COURT SAN JOSE, CA 95136 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $565 | — | $565 | 7.88% |
| EMERSON REID LLC3 | 350 5TH AVENUE # 3700 NEW YORK, NY 10118 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $203 | $203 | 10.07% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET 4TH FLOOR BOSTON, MA 02110 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $202 | — | $202 | 10.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RSC INSURANCE BROKERAGE EIN 16-1689464 BROKER | Custodial (securities) Service code 19 | — | $82K |
| ALLIED BENEFIT SYSTEMS INC. EIN 36-3086057 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $53K |
| DIRECT DENTAL ADMINISTRATORS, LLC EIN 94-3270798 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $23K |
| CIGNA EIN 59-1031071 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $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 | 234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 229 | $1.3M |
| Vision | VISION SERVICE PLAN | 217 | $38K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 234 | $69K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3 | $2K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 227 | $44K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 90 | $677K |
| Other(6 contracts, 6 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 251 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.