| 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. | $80K | $0 | $80K | 4.59% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS, CORP. | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $9K | $29K | 8.98% |
| PINNACLE BROKERS3 Filed as: PINNACLE BROKERS INS. SOLUTIONS | 2125 YGNACIO VALLEY ROAD, SUITE 200 WALNUT CREEK, CA 94598 | SUTTER HEALTH PLAN | $16K | $0 | $16K | 6.00% |
| BRETT BUTLER3 | 3386 LONDONDERRY DRIVE SANTA CLARA, CA 95050 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $14K | $21K | 18.51% |
| GREGROY L. GOLIN3 | 5822 CHARLOTTE DRIVE APARTMENT 3313 SAN JOSE, CA 95123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $0 | $8K | 7.35% |
| FRANCISCO CANPUZANO3 | 2756 TANGLEWOOD DRIVE SAN JOSE, CA 95127 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 5.00% |
| JAN HEJRET3 | 644 NORTH 17TH STREET SAN JOSE, CA 95112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $3K | $4K | 3.19% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $847 | $2K | 1.98% |
| MJ INSURANCE3 Filed as: ALICIA FRANKLIN AND VARIOUS AGENTS | 5799 ESTATES DRIVE OAKLAND, CA 94618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.98% |
| GIBRAN AHMAD CHAUDHRY3 | 20521 REID LANE SARATOGA, CA 95070 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $208 | $305 | $513 | 0.45% |
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 | 238 | 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) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 283 | $2.0M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 238 | $327K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 238 | $327K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 238 | $442K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 238 | $327K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 283 | $2.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 238 | $327K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.