| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TAMI JO SCHREINER3 | 110 E D ST STE M BENICIA, CA 94510 | KAISER FOUNDATION HEALTH PLAN, INC. | $131K | — | $131K | 5.72% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN, INC. | $23K | — | $23K | 0.98% |
| GAVIN TOMA3 Filed as: GAVIN & SCHREINER INSURANCE | 828 FIRST STREET, SUITE A BENICIA, CA 94510 | SUTTER HEALTH PLAN | $15K | — | $15K | 4.55% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | SUTTER HEALTH PLAN | $4K | — | $4K | 1.14% |
| GAVIN TOMA3 Filed as: GAVIN & SCHREINER INSURANCE | 828 FIRST STREET, SUITE A BENICIA, CA 94510 | WESTERN HEALTH ADVANTAGE | $13K | — | $13K | 5.00% |
| TAMI JO SCHREINER3 | 4529 GLENCANNON DRIVE FAIRFIELD, CA 94534 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $21K | — | $21K | 10.00% |
| GAVIN TOMA3 Filed as: GAVIN & SCHREINER INSURANCE | 828 FIRST STREET, SUITE A BENICIA, CA 94510 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 7.23% |
| TAMI JO SCHREINER3 | 110 E D ST STE M BENICIA, CA 94510 | VISION SERVICE PLAN | $2K | — | $2K | 4.63% |
| GAVIN TOMA3 Filed as: GAVIN & SCHREINER INSURANCE | 828 FIRST STREET, SUITE A BENICIA, CA 94510 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 7.31% |
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 | 265 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 321 | $2.9M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 299 | $213K |
| Vision | VISION SERVICE PLAN | 280 | $34K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 425 | $30K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 424 | $65K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLAN | 56 | $585K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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.