| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | CALIFORNIA PHYSICIANS SERVICE | $198K | $201 | $198K | 2.82% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | — | $20K | 4.00% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 3.04% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | VISION SERVICE PLAN | $3K | — | $3K | 2.32% |
| PRESIDIO BENEFITS GROUP, INC.3 | 142 SANSOME STREET, 4TH FLOOR SAN FRANCISCO, CA 94104 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| RICHTER INTERNATIONAL CONSULTING3 | 317 NW GILMAN BOULEVARD, SUITE 11 ISSAQUAH, WA 98027 | FEDERAL INSURANCE COMPANY | $536 | — | $536 | 14.99% |
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 | 205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,010 | $7.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,196 | $3K |
| Vision | VISION SERVICE PLAN | 451 | $130K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 205 | $495K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 205 | $495K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 205 | $495K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,010 | $7.4M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 360 | $510K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,196 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.