| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MIKE RADAKOVICH3 Filed as: MIKE GEORGE RADAKOVICH | 10011 N FOOTHILL BLVD. SUITE 110 CUPERTINO, CA 95014 | UNITEDHEALTHCARE INSURANCE COMPANY | $41K | — | $41K | 2.63% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA, INC. | 2300 CONTRA COSTA BLVD SUITE 375 PLEASANT HILL, CA 94523 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 0.46% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS, INC. | 10011 N. FOOTHILL BLVD SUITE 110 CUPERTINO, CA 95014 | KAISER FOUNDATION HEALTH PLANS INC. | $9K | — | $9K | 2.23% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | 2300 CONTRA COSTA BLVD SUITE 375 PLEASANT HILL, CA 94523 | KAISER FOUNDATION HEALTH PLANS INC. | $3K | — | $3K | 0.74% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS, INC | 10011 N FOOTHILL BLVD. SUITE 110 CUPERTINO, CA 95014 | KAISER FOUNDATION HEALTH PLANS, INC. | $8K | — | $8K | 2.27% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | 2300 CONTRA COSTA BLVD. SUITE 375 PLEASANT HILL, CA 94523 | KAISER FOUNDATION HEALTH PLANS, INC. | $3K | — | $3K | 0.76% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SVCS INC | E INDIANE SCHOOL RD STE 220 SCOTTSDALE, AZ 85251 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $3K | $9K | 21.71% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS BENEFITS, INC. | 10011 N FOOTHILL BLVD STE 110 CUPERTINO, CA 95014 | UNIMERICA LIFE INSURANCE COMPANY | $725 | — | $725 | 7.54% |
| ARGO INSURANCE3 | 2300 CONTRA COSTA BLVE., STE 375 PLEASANT HILL, CA 94523 | UNIMERICA LIFE INSURANCE COMPANY | $242 | — | $242 | 2.52% |
| RIS EMPLOYEE BENEFITS INC3 Filed as: RIS EMPLOYEE BENEFITS, INC. | 10011 N FOOTHILL BLVD., STE 110 CUPERTINO, CA 95014 | THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK | $871 | — | $871 | 14.99% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 325 | $2.3M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 325 | $1.6M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 325 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | UNIMERICA LIFE INSURANCE COMPANY | 174 | $15K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 74 | $42K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 325 | $1.6M |
| Other | UNIMERICA LIFE INSURANCE COMPANY | 174 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.