| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLANS INC | $25K | — | $25K | 1.96% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | KAISER FOUNDATION HEALTH PLANS INC | $16K | — | $16K | 1.25% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | UNITED HEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 3.04% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | UNITED HEALTHCARE INSURANCE COMPANY | $9K | — | $9K | 1.96% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $647 | $8K | 6.67% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.86% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 6.69% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 3.31% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | — | $2K | 21.26% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | CALIFORNIA DENTAL NETWORK, INC. | $346 | — | $346 | 9.99% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | HYATT LEGAL PLANS, INC. | $124 | $34 | $158 | 7.11% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | HYATT LEGAL PLANS, INC. | $113 | — | $113 | 5.09% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | EYEMED VISION CARE | $118 | — | $118 | 6.39% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | EYEMED VISION CARE | $49 | — | $49 | 2.65% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 189 | $1.7M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 200 | $126K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 189 | $1.3M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 141 | $57K |
| Short-term disability | AFLAC | 9 | $9K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 141 | $57K |
| Prescription drug | KAISER FOUNDATION HEALTH PLANS INC | 189 | $1.3M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 230 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.