| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $0 | $28K | 3.97% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | PO BOX 750004 PETELUMA, CA 94975 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 10.88% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $5K | $5K | 5.44% |
| ROSALIE KAY PARKS3 | 136 MARK WEST STATION ROAD WINDSOR, CA 95492 | AFLAC | $1K | $98 | $2K | 8.55% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DRIVE CORONA, CA 92883 | AFLAC | $494 | $0 | $494 | 2.79% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DRIVE SANTA ROSA, CA 95403 | AFLAC | $371 | $23 | $394 | 2.23% |
| MJ INSURANCE3 Filed as: LAURA J. RUNYEON AND VARIOUS AGENTS | 2042 WEATHERBY WAY PETALUMA, CA 94954 | AFLAC | $272 | $0 | $272 | 1.54% |
| MARK C. HUBER3 | 4164 LEISURE LANE PLACERVILLE, CA 95667 | AFLAC | $175 | $14 | $189 | 1.07% |
| SAHAR QABAZARD3 | 3756 DEER TRAIL COURT DANVILLE, CA 94506 | AFLAC | $134 | $9 | $143 | 0.81% |
| JON P BATES JR3 Filed as: JON P. BATES JR. | 440 REGENTS PARK DRIVE VALLEJO, CA 94591 | AFLAC | $65 | $0 | $65 | 0.37% |
| ANGELA MONTENEGRO3 | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $178 | $0 | $178 | 3.34% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $154 | $0 | $154 | 2.89% |
| DEGATI & ASSOCIATES INC3 Filed as: DEGATI AND ASSOCIATES INC. | 16059 23RD AVENUE WHITESTONE, NY 11357 | AFLAC | $82 | $0 | $82 | 1.54% |
| DOUGLAS MEIER3 Filed as: DOUGLAS R. MEIER | 23 ROCKLEDGE TERRACE POMPTON PLAINS, NJ 07444 | AFLAC | $66 | $0 | $66 | 1.24% |
| MARY RUSK3 | 230 EAST 71ST STREET, APARTMENT 1C NEW YORK, NY 10021 | AFLAC | $58 | $0 | $58 | 1.09% |
| RICHARD PETERSON3 | 19 IDLE DAY DRIVE CENTERPORT, NY 11721 | AFLAC | $37 | $0 | $37 | 0.69% |
| MJ INSURANCE3 Filed as: K.C. MEIER CORP. & VARIOUS AGENTS | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $24 | $0 | $24 | 0.45% |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 84 | $715K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 22 | $89K |
| Short-term disability(2 contracts) | AFLAC | 22 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 22 | $89K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 84 | $715K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 22 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 84 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.