| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SFG EMPLOYEE BENEFITS3 | 3000 OAK ROAD, SUITE 220 WALNUT CREEK, CA 94597 | BLUE CROSS OF CALIFORNIA | $67K | — | $67K | 4.53% |
| SFG EMPLOYEE BENEFITS3 | 3000 OAK ROAD, SUITE 220 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 4.62% |
| SFG EMPLOYEE BENEFITS3 | 3000 OAK ROAD, SUITE 220 WALNUT CREEK, CA 94597 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 4.53% |
| SFG EMPLOYEE BENEFITS3 | 3000 OAK ROAD, SUITE 220 WALNUT CREEK, CA 94597 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 29.46% |
| AMERICAN WORKSITE INS. MARKETING3 | 1365 WEST VISTA WAY, SUITE 201 VISTA, CA 92083 | TRANSAMERICA LIFE INSURANCE COMPANY | $899 | — | $899 | 6.09% |
| SFG EMPLOYEE BENEFITS3 | 3000 OAK ROAD, SUITE 220 WALNUT CREEK, CA 94597 | TRANSAMERICA LIFE INSURANCE COMPANY | $263 | — | $263 | 1.78% |
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 | 172 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 151 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 134 | $15K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 172 | $23K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 172 | $38K |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 13 | $15K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 151 | $1.7M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 172 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.