| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSEMARIE HINES3 | 1485 CIVIC CT STE 1400 CONCORD, CA 945205281 | KAISER FOUNDATION HEALTH PLAN, INC. | $21K | — | $21K | 1.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3 EXECUTIVE COURT STE 3 SOUTH BARRINGTON, IL 60010 | UNITEDHEALTHCARE INSURANCE COMPANY | $21K | — | $21K | 3.19% |
| ROSEMARIE HINES3 | 1485 CIVIC CT STE 1400 CONCORD, CA 945205281 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 3.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 12750 MERIT DRIVE STE 1000 PARK CENTRAL 7 DALLAS, TX 75251 | GUARDIAN | $7K | — | $7K | 9.47% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHED | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32K | $8K | $40K | 108.24% |
| ROSEMARIE HINES3 | 1485 ENEA CIR STE 1400 CONCORD, CA 945205281 | AMERITAS LIFE INSURANCE CORP. | $779 | — | $779 | 9.99% |
| CASEY JAMES KUGLER3 Filed as: CASEY KUGLER | 906 HAWKS FEATHER LN ROCKLIN, CA 957655177 | AMERITAS LIFE INSURANCE CORP. | $106 | — | $106 | 1.36% |
| BRIAN ROBERT LLOYD3 | P.O. BOX 11 KNIGHTSEN, CA 945480011 | AMERITAS LIFE INSURANCE CORP. | $106 | — | $106 | 1.36% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 208 | $1.8M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 258 | $223K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 96 | $85K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 58 | $114K |
| Short-term disability | GUARDIAN | 58 | $78K |
| Long-term disability | GUARDIAN | 58 | $78K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 58 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.