| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN INC. | $156K | $5 | $156K | 6.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | WESTERN HEALTH ADVANTAGE | $29K | — | $29K | 5.21% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | PRINCIPAL LIFE INSURANCE COMPANY | $24K | $4K | $28K | 11.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | CHINESE COMMUNITY HEALTH PLAN | $8K | — | $8K | 5.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 13.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.71% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $170 | $4K | 20.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $188 | $2K | 16.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $780 | — | $780 | 13.82% |
| SITZMANN MORRIS & LAVIS INS AGENCY3 | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | CALIFORNIA DENTAL NETWORK, INC. | $524 | — | $524 | 10.01% |
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 | 316 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 255 | $2.9M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 221 | $242K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 270 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 329 | $57K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 68 | $29K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 339 | $79K |
| Prescription drug | CHINESE COMMUNITY HEALTH PLAN | 28 | $148K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 329 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.