| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | BLUE CROSS OF CALIFORNIA | $126K | — | $126K | 3.49% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23878 PASADENA, CA 91185 | BLUE CROSS OF CALIFORNIA | $11K | — | $11K | 0.31% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $38K | — | $38K | 12.26% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 2.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $466 | — | $466 | 0.15% |
| AGIS NETWORK INC3 Filed as: AGIS NETWORK, INC. | 2122 KRATKY ROAD SAINT LOUIS, MO 63114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $875 | $11K | 10.88% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $375 | $10K | 10.38% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | VISION SERVICE PLAN | $2K | — | $2K | 3.35% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $174 | — | $174 | 0.34% |
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 | 374 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 627 | $3.7M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 26 | $87K |
| Vision | VISION SERVICE PLAN | 190 | $51K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 374 | $309K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 374 | $309K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 374 | $309K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 627 | $3.7M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 374 | $409K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 627 | — |
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.