| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MAROEVICH, O'SHEA AND COGHLAN INS.3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $109K | $58 | $109K | 5.00% |
| MAROEVICH, O'SHEA AND COGHLAN INS.3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | PRINCIPAL LIFE INSURANCE COMPANY | $27K | $3K | $31K | 8.94% |
| AMWINS3 Filed as: LISI, LLC | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $4K | $14K | 4.05% |
| GREGORY L GOLIN3 Filed as: GREGORY L. GOLIN | 5822 CHARLOTTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $0 | $7K | 6.51% |
| ROSA MURILLO PUENTE3 | 6143 UTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $631 | $160 | $791 | 0.79% |
| CATHERINE LISA LUKE3 | 4787 WEST HACIENDA AVENUE CAMPBELL, CA 95008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $538 | $56 | $594 | 0.59% |
| MJ INSURANCE3 Filed as: BARRY W. MAAS AND VARIOUS AGENTS | 1272 WEST MORAGA ROAD FRESNO, CA 93711 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $490 | $1 | $491 | 0.49% |
| ANTONIO JOSE ANGELES3 | 1858 ALLISON WAY SAN JOSE, CA 95132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $368 | $5 | $373 | 0.37% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $258 | $0 | $258 | 0.26% |
| PINC INSURANCE SVCS3 Filed as: PINC INSURANCE SERVICES, INC. | UNKNOWN SAN FRANCISCO, CA 94107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $188 | $0 | $188 | 0.19% |
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 | 231 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 357 | $2.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 612 | $344K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 612 | $344K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 612 | $445K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 612 | $344K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 357 | $2.2M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 612 | $344K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 612 | — |
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.