| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD, SUITE 800 CONCORD, CA 94520 | BLUE CROSS OF CALIFORNIA | $54K | — | $54K | 5.31% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 3.83% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DRIVE CORONA, CA 92883 | AFLAC | $1K | $67 | $1K | 7.40% |
| MJ INSURANCE3 Filed as: MARK HUBER AND VARIOUS AGENTS | 480 SAN GABRIEL DRIVE SONOMA, CA 95476 | AFLAC | $657 | $18 | $675 | 3.36% |
| ROSALIE KAY PARKS3 | 136 MARK WEST STATION ROAD WINDSOR, CA 95492 | AFLAC | $226 | — | $226 | 1.13% |
| SANDRA SUE ROBISON3 | 238 KING ROAD PETALUMA, CA 94952 | AFLAC | $118 | — | $118 | 0.59% |
| JON P BATES JR3 Filed as: JON P. BATES | 440 REGENTS PARK DRIVE VALLEJO, CA 94591 | AFLAC | $116 | — | $116 | 0.58% |
| MICHAEL BOOTH3 Filed as: MICHAEL H. BOOTH | 740 4TH STREET SANTA ROSA, CA 95404 | AFLAC | $112 | — | $112 | 0.56% |
| SHANE EDMUND ATTEBERY3 | 1260 NORTH DUTTON AVENUE SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $80 | — | $80 | 0.40% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | EPIC OPERATING FILE 1367 PASADENA, CA 91199 | VISION SERVICE PLAN | $1K | — | $1K | 5.66% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN STREET, 21ST FLOOR SAN FRANCISCO, CA 94105 | MANAGED HEALTH NETWORK | $502 | — | $502 | 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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 109 | $1.4M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 147 | $1.1M |
| Vision | VISION SERVICE PLAN | 155 | $19K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 109 | $1.0M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 109 | $1.0M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 109 | $1.4M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 183 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.