| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 180 HOWARD STREET SUITE 200 SAN FRANCISCO, CA 94105 | BLUE CROSS OF CALIFORNIA (G0200) | $65K | — | $65K | 4.90% |
| ALEXANDER BEDROSIAN3 | 525 VETERANS BLVD. #102 REDWOOD CITY, CA 94063 | BLUE CROSS OF CALIFORNIA (G0200) | $6K | — | $6K | 0.43% |
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 | 192 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA (G0200) | 305 | $1.3M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 342 | $215K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 342 | $215K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 342 | $215K |
| Prescription drug | BLUE CROSS OF CALIFORNIA (G0200) | 305 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 342 | — |
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.