| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | KAISER FOUNDATION HEALTH PLAN INC | $70K | $0 | $70K | 5.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $5K | $25K | 7.85% |
| PRIMPAY, LLC5 Filed as: PRIMPAY/SYNCHR | 1487 DUNWOODY DRIVE WEST CHESTER, PA 19380 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 1.58% |
| PINNACLE BROKERS3 Filed as: PINNACLE BROKERS INS. SOLUTIONS | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | SUTTER HEALTH PLAN | $13K | $0 | $13K | 6.00% |
| GREGROY L. GOLIN3 | 5822 CHARLOTTE DRIVE APARTMENT 3313 SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $0 | $8K | 9.39% |
| ALICIA FRANKLIN3 | 5799 ESTATES DRIVE OAKLAND, CA 94618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.51% |
| JAN HEJRET3 | 644 NORTH 17ST STREET SAN JOSE, CA 95112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $434 | $916 | $1K | 1.56% |
| MARK TETSUO IWASAKI3 Filed as: MARK TETSUO IWASAKI & OTHER AGENTS | 133 CRABAPLE COURT HERCULES, CA 94547 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $11 | $1K | 1.18% |
| ANDREA MARIE TIERCE3 Filed as: ANDREA MARIE TUERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $610 | $365 | $975 | 1.13% |
| BETHANY ROSE MAIER3 | 1729 NORTH 1ST STREET APARTMENT 10415 SAN JOSE, CA 95112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $110 | $425 | $535 | 0.62% |
| CATHERINE LISA LUKE3 | 9351 OAK VIEW DRIVE OAKDALE, CA 95361 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $252 | $0 | $252 | 0.29% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 279 | $1.6M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $315K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $315K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $402K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $315K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 279 | $1.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 233 | $315K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.