| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $148 | $14K | 3.78% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $100K | $5K | $104K | 29.42% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 10.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $761 | $6K | 13.97% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.00% |
| SAMANTHA IVANCICH3 | PO BOX 8313 SAN JOSE, CA 95155 | AFLAC | $330 | $0 | $330 | 3.19% |
| MJ INSURANCE3 Filed as: DERREK KECK AND VARIOUS AGENTS | 18080 DAMIAN WAY SALINAS, CA 93907 | AFLAC | $230 | $30 | $260 | 2.51% |
| NANCY E ODOM3 Filed as: NANCY E. ODOM | 5921 STONE MEADOW DRIVE PLANO, TX 75093 | AFLAC | $130 | $68 | $198 | 1.91% |
| FALCE BENEFITS GROUP INC.3 Filed as: FALCE BENEFITS GROUP INC | 191 CYPRESS LANE WATSONVILLE, CA 95076 | AFLAC | $121 | $0 | $121 | 1.17% |
| MICHAEL ANTHONY DURRE3 Filed as: MICHAEL E. DOLINAR | 21908 DEE DRIVE BEND, OR 97701 | AFLAC | $83 | $0 | $83 | 0.80% |
| JOSEPH P CALARCO3 Filed as: JOSEPH J. CANEPA | 61390 HUCKLEBERRY PLACE BEND, OR 97702 | AFLAC | $79 | $0 | $79 | 0.76% |
| DAVID MARTIN GUSTAFSON3 Filed as: DAVID GUSTAFSON | 5921 STONE MEADOW DRIVE PLANO, TX 75093 | AFLAC | $56 | $11 | $67 | 0.65% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 98 | $718K |
| Dental | DELTA DENTAL OF CALIFORNIA | 164 | $84K |
| Vision | VISION SERVICE PLAN | 57 | $24K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $43K |
| Short-term disability | AFLAC | 11 | $10K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $43K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 98 | $718K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.