| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | HEALTH NET | $136K | — | $136K | 3.41% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 100 WALNUT CREEK, CA 94596 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 3.50% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | UNITED CONCORDIA INSURANCE COMPANY | $1K | — | $1K | 2.99% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 5608 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $648 | — | $648 | 3.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ABC -NCC EIN 92-3378739 SPONSOR | Contract Administrator Service code 13 | — | $138K |
| WOLDS LAW GROUP EIN 80-0462356 LEGAL | Legal Service code 29 | — | $82K |
| GALLINA LLP EIN 94-2147510 ACCOUNTING | Accounting (including auditing) Service code 10 | — | $51K |
| UAS EIN 94-1749354 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $48K |
| HUB CONSULTING EIN 33-0315047 BROKERAGE | Insurance brokerage commissions and fees Service code 53 | — | $25K |
| KEVIN SALTMAN EIN 20-0142443 BROKERAGE | Insurance brokerage commissions and fees Service code 53 | — | $24K |
| POLYCOMP EIN 95-2889854 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $17K |
| DC AND ASSOCIATES EIN 46-3897829 BROKERAGE | Insurance brokerage commissions and fees Service code 53 | — | $15K |
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 | 446 | 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) | 446 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 371 | $158K |
| Vision | VISION SERVICE PLAN | 389 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 371 | $114K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 371 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.