| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC. | 1 WILLOWBROOK COURT PETALUMA, CA 94954 | CALIFORNIA PHYSICIANS SERVICE | $22K | $0 | $22K | 3.84% |
| PORTAL INSURANCE AGENCY, INC.3 Filed as: PORTAL INSURANCE AGENCY INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | CALIFORNIA PHYSICIANS SERVICE | $7K | $0 | $7K | 1.16% |
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC. | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 2.62% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES OF CA. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 0.73% |
| SSM INSURANCE SERVICES, INC.3 Filed as: SSM INSURANCE SERVICES INC. | PO BOX 750004 PETALUMA, CA 94975 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.13% |
| EMERSON REID LLC3 | 5200 NORTH PALM AVENUE, SUITE 114 FRESNO, CA 93704 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.18% |
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION BENEFITS AND SOLUTIONS | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $591 | $0 | $591 | 2.18% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 72 | $1.1M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 125 | $27K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 125 | $27K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 125 | $27K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 72 | $1.1M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 125 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.