| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROBITY INSURANCE SERVICES3 | 1100 E HAMILTON AVE STE 1 CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS' SERVICE | $33K | — | $33K | 5.22% |
| PROBITY INSURANCE SERVICES3 | 1100 E HAMILTON AVE STE 1 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC | $2K | — | $2K | 2.16% |
| PROBITY INSURANCE SERVICES3 | 1100 E HAMILTON AVE STE 1 CAMPBELL, CA 95008 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 11.94% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 6155 ALMADEN EXPY STE 210 SAN JOSE, CA 95120 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.08% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | ATTN COMMISSIONS DEPARTMENT 1787 SENTRY PKWY W BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $397 | $397 | 0.52% |
| PROBITY INSURANCE SERVICES3 | 1100 E HAMILTON AVE STE 1 CAMPBELL, CA 95008 | RELIANCE STANDARD | $23K | — | $23K | 100.00% |
| PROBITY INSURANCE SERVICES3 | 1100 E HAMILTON AVE STE 1 CAMPBELL, CA 95008 | RELIANCE STANDARD | $2K | — | $2K | 8.69% |
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 | 157 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 61 | $722K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 70 | $77K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 70 | $77K |
| Life insurance | RELIANCE STANDARD | 157 | $17K |
| Long-term disability | RELIANCE STANDARD | 163 | $23K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 61 | $637K |
| Other | RELIANCE STANDARD | 157 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.