| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 135 MAIN ST 21ST FLOOR SAN FRANCISCO, CA 94105 | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | — | $86K | $86K | 4.19% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST 24TH FL SAN FRANCISCO, CA 94104 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $2K | $8K | 14.39% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $68 | $68 | 0.13% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 10.04% |
| REMMEL SOLUTIONS4 | 1183 SWALLOWTAIL WAY NIPOMO, CA 93444 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $858 | — | $858 | 14.31% |
| EDGEWOOD PARTNERS INSURANCE CENTER4 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94520 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $449 | — | $449 | 7.49% |
| LINDA J. CASH4 | 3430 TULLY ROAD SUITE 20-426 MODESTO, CA 95350 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $21 | — | $21 | 0.35% |
| MINES INSURANCE SERVICES INC3 | 1519 BARTH AVE RICHMOND, CA 94806 | AFLAC | $2K | $79 | $2K | — |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 734004 CHICAGO, IL 60673 | AFLAC | $676 | — | $676 | — |
| KRISTINA J KUNZ3 | 118 GRANVILLE WAY SAN FRANCISCO, CA 94127 | AFLAC | $122 | $18 | $140 | — |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN DANIEL PAYNE | 3572 SHADOWTREE LN CHICO, CA 95928 | AFLAC | $129 | — | $129 | — |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FL 6 SAN DIEGO, CA 92101 | AFLAC | $72 | — | $72 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $61 | — | $61 | — |
| JUSTIN M REYNOLDS3 | 8433 ENTERPRISE CIR STE 100 LAKEWOOD RANCH, FL 34202 | AFLAC | $59 | — | $59 | — |
| JON P BATES JR3 | 440 REGENTS PARK DR VALLEJO, CA 94591 | AFLAC | $45 | — | $45 | — |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $41 | — | $41 | — |
| SERGIO I GARCIA3 | 8876 A C SKINNER PKWY UNIT 1201 JACKSONVILLE, FL 32256 | AFLAC | $40 | — | $40 | — |
| SAHAR QABAZARD3 | 3756 DEER TRAIL CT DANVILLE, CA 94506 | AFLAC | $23 | — | $23 | — |
| MANA INSURANCE SOLUTIONS INC3 | PO BOX 930 MAKAWAO, HI 96768 | AFLAC | $18 | — | $18 | — |
| REBECCA J HANEY3 | 2300 HEMLOCK AVE CONCORD, CA 94520 | AFLAC | $14 | — | $14 | — |
| GUILLERMO H PALOMINO3 | 2319 E EDNA AVE PHOENIX, AZ 85022 | AFLAC | $13 | — | $13 | — |
| VICTORIA L FLYNN3 Filed as: VICTORIA HOWARD | 1365 CAMINO PERAL #A MORAGA, CA 94556 | AFLAC | $10 | — | $10 | — |
| KEVIN DAVID KIME3 | 1708 MAKEFIELD ROAD YARDLEY, PA 19087 | AFLAC | $3 | — | $3 | — |
| SARAH ELIZABET SPINA3 | 5158 MCCOY AVE SAN JOSE, CA 95130 | AFLAC | $3 | — | $3 | — |
| LAUREL NICOLE HARMS3 | 785 TURRINI DR DANVILLE, CA 94526 | AFLAC | $2 | — | $2 | — |
| WILLIAM G SHIELDS3 Filed as: WILLIAM G SHEILDS | 4658 VISTA STREET SAN DIEGO, CA 92116 | AFLAC | $2 | — | $2 | — |
| JEROME RAYMOND STRAYVE JR3 Filed as: JEROME RAYMOND STRAYVE JR. | 2358 UNIVERISTY AVE 776 SAN DIEGO, CA 92104 | AFLAC | $2 | — | $2 | — |
| PAUL GLOBAL BENEFITS INC3 Filed as: PAUL SCHNAIDER | 2521 SHADOWBROOKE RD BRENTWOOD, CA 94513 | AFLAC | $1 | — | $1 | — |
| EDWARD M RYSKA3 | 6010 ROBLAR RD PETALUMA, CA 94952 | AFLAC | $1 | — | $1 | — |
| ANDREW R GRETHEL3 Filed as: ANDREW R. GRETHEL | 11739 HICKORY RUN COURT LOVELAND, OH 45140 | AFLAC | $1 | — | $1 | — |
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 | 332 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 337 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | 275 | $2.0M |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 163 | $33K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 332 | $52K |
| Short-term disability | AFLAC | 39 | $0 |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 332 | $52K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA PHYSICIANS' SERVICE | 275 | $2.0M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 332 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.