| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $37K | $37K | 2.41% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES OF CA | 2 PARK PLAZA SUITE 440 IRVINE, CA 92614 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $36K | — | $36K | 2.32% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES INC. | 500 YGNACIO VALLEY ROAD SUITE 450 WALNUT CREEK, CA 94546 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $28K | $28K | 1.84% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $21K | — | $21K | 1.35% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN, INC. | $26K | $19 | $26K | 5.34% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES INC. | 500 YGNACIO VALLEY ROAD SUITE 450 WALNUT CREEK, CA 94596 | HUMANA INSURANCE COMPANY | $10K | — | $10K | 4.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES OF CA | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 2.17% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 0.85% |
| EPIC3 Filed as: ASCENDE DIVISON OF EPIC | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | HUMANA INSURANCE COMPANY | $371 | — | $371 | 0.19% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES OF CA | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 3.08% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN, INC. | $231 | — | $231 | 0.51% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES OF CA | 2401 E KATELLA AVENUE SUITE 550 ANAHEIM, CA 92806 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.61% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES OF CA | 2401 E KATELLA AVENUE SUITE 550 ANAHEIM, CA 92806 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $907 | — | $907 | 2.64% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 20.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD SUITE 100 LAFAYETTE, CA 94549 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.38% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVCIES OF CA | 2401 E KATELLA AVENUE SUITE 550 ANAHEIM, CA 92806 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $494 | — | $494 | 2.63% |
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. |
| Total participants (= "Plan participants" tile) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 211 | $2.5M |
| Dental(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 166 | $616K |
| Vision(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 211 | $1.7M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $53K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $39K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 76 | $528K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.