| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEBORAH UPLAND3 | 1519 S B ST SAN MATEO, CA 944022435 | KAISER FOUNDATION HEALTH PLAN INC | $27K | — | $27K | 4.50% |
| DEBORAH UPLAND3 Filed as: DEBORAH E UPLAND | 1519 SOUTH B STREET SAN MATEO, CA 94402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.50% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS INC | 1550 W COLORADO BLVD PASADENA, CA 91105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $78 | — | $78 | 0.09% |
| UPLAND, DEBORAH E3 Filed as: UPLAND, DEBORAH ELAINE | C/O BPIA 1519 SOUTH B STREET SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $852 | — | $852 | 11.00% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 26 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 111 | $609K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $87K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 81 | $8K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 81 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.