| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | BLUE CROSS OF CALIFORNIA | $93K | $0 | $93K | 4.95% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $0 | $24K | 3.77% |
| ALAN FONG INSURANCE SERVICES3 Filed as: ALAN FONG INSURANCE SERVICES INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 1.28% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 5.15% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 3.64% |
| UBF INSURANCE SERVICES, INC.3 Filed as: UBF INSURANCE SERVICES, INC | 2033 NORTH MAIN STREET, SUITE 700 WALNUT CREEK, CA 94596 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 16.26% |
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 | 216 | 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) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 401 | $2.5M |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $309K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $209K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $209K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 401 | $2.5M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 218 | $309K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.