| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOC INSURANCE SERVICES3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $100K | $5 | $100K | 5.00% |
| MOC INSURANCE SERVICES3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | SUTTER HEALTH PLAN | $26K | $0 | $26K | 6.00% |
| MOC INSURANCE SERVICES3 | 101 MONTGOMERY STREET, SUITE 800 SAN FRANCISCO, CA 94104 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $5K | $33K | 11.52% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $5K | $19K | 6.42% |
| GREGORY L GOLIN3 Filed as: GREGORY L. GOLIN | 5822 CHARLOTTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $0 | $6K | 6.63% |
| PINC INSURANCE SVCS3 Filed as: PINC INS SVCS INC. AND OTHER AGENTS | UNKNOWN SAN FRANCISCO, CA 94107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $515 | $0 | $515 | 0.59% |
| CATHERINE LISA LUKE3 | 4787 WEST HACIENDA AVENUE CAMPBELL, CA 95008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $438 | $32 | $470 | 0.53% |
| MARK TETSUO IWASAKI3 | 133 CRABAPPLE COURT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $316 | $0 | $316 | 0.36% |
| ANTONIO JOSE ANGELES3 | 1858 ALLISON WAY SAN JOSE, CA 95132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $269 | $0 | $269 | 0.31% |
| ROSA MURILLO PUENTE3 | 6143 UTE DRIVE SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $253 | $0 | $253 | 0.29% |
| BARRY W MAAS3 Filed as: BARRY W. MAAS | 1272 WEST MORAGA ROAD FRESNO, CA 93711 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $240 | $0 | $240 | 0.27% |
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 | 225 | 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) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 297 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $290K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $290K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $378K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $290K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 297 | $2.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $290K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 549 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.