| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAULA HECKLER3 Filed as: PAULA MARIE HECKLER | 3000 EXECUTIVE PARKWAY SUITE 400 SAN RAMON, CA 94583 | BLUE CROSS OF CALIFORNIA | $56K | — | $56K | 4.98% |
| PAULA HECKLER3 | PO BOX 5154 SAN RAMON, CA 94583 | KAISER FOUNDATION HEALTH PLANS INC | $37K | — | $37K | 3.68% |
| NANCY E KOSKI3 Filed as: NANCY KOSKI | 1173 HARKER AVENUE PALO ALTO, CA 94301 | KAISER FOUNDATION HEALTH PLANS INC | $13K | — | $13K | 1.32% |
| PAULA HECKLER3 | — | DELTA DENTAL OF CALIFORNIA | $6K | — | $6K | 2.20% |
| NANCY E KOSKI3 | — | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 0.80% |
| PAULA M HECKLER3 | 345 BEACON RIDGE LANE WALNUT CREEK, CA 94597 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 9.38% |
| NANCY E KOSKI3 | 1173 HARKER AVE PALO ALTO, CA 94301 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.25% |
| PAULA M HECKLER3 | PO BOX 5154 SAN RAMON, CA 94583 | VISION SERVICE PLAN | $1K | — | $1K | 2.94% |
| NANCY E KOSKI3 Filed as: NANCY KOSKI | 1173 HARKER AVENUE PALO ALTO, CA 94301 | VISION SERVICE PLAN | $478 | — | $478 | 1.27% |
| PAULA HECKLER3 | — | CONCERN | $753 | — | $753 | 5.00% |
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 | 208 | 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) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 107 | $2.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 179 | $261K |
| Vision | VISION SERVICE PLAN | 186 | $38K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 204 | $79K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 204 | $79K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.