| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSEMARIE HINES3 | 1485 CIVIC CT STE 1400 CONCORD, CA 945205281 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | — | $18K | 2.00% |
| ROSEMARIE HINES3 | 1485 CIVIC CT STE 1400 CONCORD, CA 945205281 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | — | $19K | 3.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3 EXECUTIVE COURT STE 3 SOUTH BARRINGTON, IL 60010 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 0.32% |
| ROSEMARIE HINES3 | 1030 SANTA LUCIA DR PLEASANT HILL, CA 945232336 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.41% |
| ROSEMARIE HINES3 | 1485 ENEA CIR STE 1400 CONCORD, CA 945205281 | GUARDIAN | $8K | — | $8K | 7.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 12750 MERIT DRIVE STE 1000 PARK CENTRAL 7 DALLAS, TX 75251 | GUARDIAN | $772 | $644 | $1K | 1.48% |
| THE HORTON GROUP3 | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | GUARDIAN | $724 | — | $724 | 0.76% |
| PACIFIC ADVISORS LLC3 | 333 INDIAN HILL BLVD. CLAREMONT, CA 91711 | GUARDIAN | $149 | — | $149 | 0.16% |
| H E INSURANCE INC3 Filed as: H E INSURANCE INC. | 7 HANOVER SQ NEW YORK, NY 10004 | GUARDIAN | $4 | — | $4 | 0.00% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHED | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $2K | $14K | 34.16% |
| ROSEMARIE HINES3 | 1485 ENEA CIR STE 1400 CONCORD, CA 945205281 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 10.00% |
| CASEY JAMES KUGLER3 Filed as: CASEY KUGLER | 906 HAWKS FEATHER LN ROCKLIN, CA 957655177 | AMERITAS LIFE INSURANCE CORP. | $146 | — | $146 | 1.29% |
| BRIAN ROBERT LLOYD3 | P.O. BOX 11 KNIGHTSEN, CA 945480011 | AMERITAS LIFE INSURANCE CORP. | $146 | — | $146 | 1.29% |
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 | 104 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 129 | $1.5M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 192 | $200K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 110 | $107K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 68 | $138K |
| Short-term disability | GUARDIAN | 68 | $96K |
| Long-term disability | GUARDIAN | 68 | $96K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 68 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.