| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CALIFORNIA PHYSICIANS SERVICE | $9K | — | $9K | 3.07% |
| CHRISTOPHER A HAMMETT3 Filed as: CHRISTOPHER A. HAMMETT | 6155 ALMADEN EXPRESSWAY, SUITE 210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS SERVICE | $2K | — | $2K | 0.81% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 N. CALIFORNIA BLVD., STE. 1000 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 3.54% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $351 | — | $351 | 9.92% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 122 | $357K |
| Dental | DELTA DENTAL OF CALIFORNIA | 193 | $27K |
| Vision | VISION SERVICE PLAN | 114 | $4K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $15K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $15K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 122 | $357K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.