| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | CALIFORNIA PHYSICIANS' SERVICE | $21K | $219K | $239K | 3.92% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2121 N CALIFORNIA BLVD SUITE 1000 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $31K | $6 | $31K | 3.48% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | — | $537 | $537 | 0.06% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 4.02% |
| AXA ASSISTANCE, USA3 Filed as: AXA ASSISTANCE,USA | 122 SOUTH MICHIGAN AVE STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $105 | $105 | 0.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $2K | — | $2K | 2.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 317 NW GILMAN BLVD, STE 51 ISSAQUAH, WA 98027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 317 NW GILMAN BOULEVARD SUITE 51 ISSAQUAH, WA 98027 | FEDERAL INSURANCE COMPANY | $832 | — | $832 | 18.70% |
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 | 298 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 325 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 260 | $7.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 974 | $0 |
| Vision | VISION SERVICE PLAN | 320 | $100K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 298 | $472K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 298 | $472K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 298 | $472K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 260 | $7.0M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 316 | $495K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 974 | — |
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."
No prospect flags tripped on this filing.