| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $32K | $0 | $32K | 3.88% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | PO BOX 750004 PETALUMA, CA 94975 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $0 | $11K | 10.00% |
| 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 | $8K | $8K | 7.76% |
| ROSALIE KAY PARKS3 | 136 MARK WEST STATION ROAD WINDSOR, CA 95492 | AFLAC | $490 | $48 | $538 | 3.75% |
| MICHAEL J. MCVAY3 | 8967 CREST VIEW DRIVE CORONA, CA 92883 | AFLAC | $460 | $0 | $460 | 3.20% |
| MJ INSURANCE3 Filed as: DAVID B. KITCHEN AND VARIOUS AGENTS | 5230 HARTER LANE LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $252 | $11 | $263 | 1.83% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DRIVE SANTA ROSA, CA 95403 | AFLAC | $168 | $11 | $179 | 1.25% |
| MARK C. HUBER3 | 1100 COLD SPRINGS ROAD PLACERVILLE, CA 95667 | AFLAC | $127 | $0 | $127 | 0.88% |
| JON P BATES JR3 Filed as: JON P. BATES JR | 440 REGENTS PARK DRIVE VALLEJO, CA 94591 | AFLAC | $60 | $0 | $60 | 0.42% |
| LAURA RUNYEON3 Filed as: LAURA J. RUNYEON | 2042 WEATHERBY WAY PETALUMA, CA 94954 | AFLAC | $46 | $0 | $46 | 0.32% |
| ANGELA MONTENEGRO3 | 74 HILLANDALE DRIVE NEW ROCHELLE, NY 10804 | AFLAC | $103 | $0 | $103 | 2.65% |
| DEGATI & ASSOCIATES INC3 Filed as: DEGATI & ASSOCIATES, INC. | 16059 23RD AVENUE WHITESTONE, NY 11357 | AFLAC | $74 | $0 | $74 | 1.90% |
| MARY RUSK3 | 230 EAST 71ST STREET, APARTMENT 1C NEW YORK, NY 10021 | AFLAC | $44 | $0 | $44 | 1.13% |
| RICHARD PETERSON3 | 19 IDLE DAY DRIVE CENTERPORT, NY 11721 | AFLAC | $34 | $0 | $34 | 0.87% |
| DOUGLAS MEIER3 Filed as: DOUGLAS R. MEIER | 23 ROCKLEDGE TERRACE POMPTON PLAINS, NJ 07444 | AFLAC | $27 | $0 | $27 | 0.69% |
| KENNETH C MEIER CORP3 Filed as: KENNETH C. MEIER CORP. | 19 MARKWOOD ROAD GARDEN CITY, NY 11530 | AFLAC | $17 | $0 | $17 | 0.44% |
| BENITO A ROTONDI II INC3 Filed as: BENITO A ROTONDI II, INC AND AGENTS | 23 PINE RIDGE ROAD SARATOGA SPRINGS, NY 12866 | AFLAC | $5 | $0 | $5 | 0.13% |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 79 | $814K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 319 | $109K |
| Short-term disability(2 contracts) | AFLAC | 17 | $18K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 319 | $109K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 79 | $814K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 319 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.