| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $49K | — | $49K | 4.57% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | SUTTER HEALTH PLAN | $7K | — | $7K | 5.00% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $3K | $13K | 13.15% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 10.00% |
| HIXME INSURANCE SOLUTIONS, INC.3 Filed as: HIXME INSURANCE SOLUTIONS | 27489 AGOURA RD, STE 100 AGOURA HILLS, CA 91301 | EYEMED VISION CARE | $679 | — | $679 | 11.59% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $542 | — | $542 | 9.68% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | CALIFORNIA DENTAL NETWORK, INC. | $358 | — | $358 | 10.00% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 151 | $1.2M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 86 | $100K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 151 | $1.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 120 | $41K |
| Short-term disability | AFLAC | 6 | $6K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 120 | $41K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 151 | $1.2M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 230 | $52K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.