| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 7500 OLD GEORGETOWN ROAD SUITE 1225 BETHESDA, MD 20814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $7K | $33K | 5.40% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $4K | $16K | 2.62% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 0.36% |
| ACRISURE LLC3 Filed as: ACRISURE PTRS. WEST COAST INS. SVS. | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $958 | $0 | $958 | 0.16% |
| ALLIED ADMINISTRATORS3 Filed as: ALLIED ADMINISTRATORS, INC. | UNKNOWN BERKELEY, CA 94710 | DELTA DENTAL OF CALIFORNIA | $4K | $0 | $4K | 0.64% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 4.29% |
| NONSTOP ADMINISTRATION & INSURANCE3 Filed as: NONSTOP ADMIN. AND INS. SERVICES | 1800 SUTTER STREET, SUITE 730 CONCORD, CA 94520 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.82% |
| ACRISURE LLC3 Filed as: ACRISURE PTRS. WEST COAST INS. SVS. | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $0 | $19 | 0.02% |
| JOHN GREENBAUM3 | 700 AIRPORT BOULEVARD BURLINGAME, CA 94010 | LANDMARK HEALTHPLAN | $10K | $0 | $10K | 10.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | VISION SERVICE PLAN | $6K | $0 | $6K | 6.65% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 811 MADISON AVENUE TOLEDO, OH 43604 | VISION SERVICE PLAN | $3K | $0 | $3K | 3.36% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY LLC | 1 INTEGRITY PARKWAY CLEVELAND, OH 44143 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.66% |
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 | 969 | 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) | 969 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 857 | $9.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,214 | $575K |
| Vision | VISION SERVICE PLAN | 568 | $86K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 969 | $727K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 969 | $727K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 969 | $615K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 857 | $9.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,169 | $888K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,169 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.