| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | SUTTER HEALTH PLAN | $19K | — | $19K | 3.25% |
| DEBORAH UPLAND3 | 1519 SOUTH B STREET SAN MATEO, CA 94402 | SUTTER HEALTH PLAN | $4K | — | $4K | 0.74% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 3.55% |
| DEBORAH UPLAND3 | 1519 SOUTH B STREET SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 0.79% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | WESTERN HEALTH ADVANTAGE | $11K | — | $11K | 4.97% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.25% |
| DEBORAH UPLAND3 Filed as: DEBORAH E UPLAND | 1519 SOUTH B STREET SAN MATEO, CA 94402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $930 | — | $930 | 0.72% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $45 | $1K | 7.30% |
| DEBORAH UPLAND3 | 1519 SOUTH B STREET SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | $474 | — | $474 | 2.78% |
| VARIOUS - SEE ATTACHED3 Filed as: CONTINENTAL AMERICAN - SEE ATTACHED | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 28.29% |
| ROBERT M NISSIM4 | 1038 BANCROFT ROAD CONCORD, CA 94518 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $100 | — | $100 | 4.31% |
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 | 257 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | SUTTER HEALTH PLAN | 90 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $128K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 257 | $17K |
| Prescription drug(3 contracts, 3 carriers) | SUTTER HEALTH PLAN | 90 | $1.2M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 257 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.