| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOC INSURANCE SERVICES3 | 44 MONTGOMERY STREET, SUITE 1700 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $107K | — | $107K | 5.00% |
| MOC INSURANCE SERVICES3 | 44 MONTGOMERY STREET, SUITE 1700 SAN FRANCISCO, CA 94104 | PRINCIPAL LIFE INSURANCE COMPANY | $32K | $11K | $44K | 10.76% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICES, INC. | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94402 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $2K | $14K | 3.48% |
| GREGORY L GOLIN3 Filed as: GREGORY L. GOLIN | 5822 CHARLOTTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17K | $0 | $17K | 14.45% |
| MJ INSURANCE3 Filed as: MICHAEL LEBRANE AND VARIOUS AGENTS | 808 EAST 5TH AVEN SAN MATEO, CA 94402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $206 | $5K | 4.22% |
| KAMALA J COBURN3 Filed as: KAMALA JO COBURN | 934 LONGWOOD LANE SAN JOSE, CA 95129 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $240 | $2K | $2K | 1.83% |
| SARAH PALOMINO-GAETA3 | 16725 FOUNTAIN AVENUE MORGAN HILL, CA 95037 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $36 | $1K | 1.26% |
| JULIA JOANNA PUJOLS3 | 10720 WALLACE LANE DUBLIN, CA 94568 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $67 | $1K | 1.14% |
| ANTONIO JOSE ANGELES3 | 1127 KOCH LANE SAN JOSE, CA 95125 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $69 | $1K | 1.11% |
| MARK TETSUO IWASAKI3 | 133 CRABAPLE COURT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.07% |
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 | 233 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 418 | $2.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 646 | $405K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 646 | $405K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 646 | $523K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 646 | $405K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 418 | $2.3M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 646 | $523K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 646 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.