| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAROEVICH, O'SHEA AND COGHLAN INS.3 Filed as: MAROEVICH, O'SHEA & COGHLAN INS. | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $107K | $0 | $107K | 4.60% |
| MAROEVICH, O'SHEA AND COGHLAN INS.3 Filed as: MAROEVICH OSHEA & COGHLAN INS. INC. | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | PRINCIPAL LIFE INSURANCE COMPANY | $30K | $4K | $34K | 8.81% |
| LEBHERZ INSURANCE SERVICES INC3 Filed as: LEBHERZ INSURANCE SERVICES, INC. | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $2K | $14K | 3.53% |
| GREGORY L GOLIN3 Filed as: GREGORY L. GOLIN | 5822 CHARLOTTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 8.25% |
| CATHERINE LISA LUKE3 | 4787 WEST HACIENDA AVENUE CAMPBELL, CA 95008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $726 | $470 | $1K | 1.07% |
| ANTONIO JOSE ANGELES3 | 1127 KOCH LANE SAN JOSE, CA 95125 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $38 | $1K | 0.97% |
| MJ INSURANCE3 Filed as: MARK IWASAKI AND VARIOUS AGENTS | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $934 | $37 | $971 | 0.87% |
| ROSA MURILLO PUENTE3 | 6143 UTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $595 | $106 | $701 | 0.63% |
| PINC INSURANCE SVCS3 Filed as: PINC INSURANCE SERVICES, INC. | UNKNOWN SAN FRANCISCO, CA 94107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $283 | $0 | $283 | 0.25% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | PO BOX 5809 FRESNO, CA 93755 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $263 | $0 | $263 | 0.24% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 366 | $2.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 619 | $383K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 619 | $383K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 619 | $495K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 619 | $383K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 366 | $2.3M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 619 | $383K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 619 | — |
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.