| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACK NOVICIO INSURANCE AGENCY INC3 | 2745 CROSBY WAY SACRAMENTO, CA 95815 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | — | $16K | 4.19% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 0.57% |
| RONALD HUPERT3 Filed as: RONALD HUPPERT | 1700 N BROADWAY, STE 380 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $554 | — | $554 | 0.14% |
| JACK NOVICIO INSURANCE AGENCY INC3 | 3400 WATT AVE, STE 203 SACRAMENTO, CA 95821 | CALIFORNIA PHYSICIANS SERVICE | $3K | — | $3K | 3.95% |
| ZENDARSKI, THOMAS PAUL3 | 6540 LONETREE BLVD., STE 100 ROCKLIN, CA 95765 | CALIFORNIA PHYSICIANS SERVICE | $2K | — | $2K | 2.24% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | CALIFORNIA PHYSICIANS SERVICE | $638 | — | $638 | 0.92% |
| HUPPERT, RONALD HERBERT3 | 1700 N BROADWAY, STE 380 WALNUT CREEK, CA 94596 | CALIFORNIA PHYSICIANS SERVICE | $83 | — | $83 | 0.12% |
| JACK NOVICIO INSURANCE AGENCY INC3 | 3400 WATT AVE, STE 203 SACRAMENTO, CA 95815 | UNITED CONCORDIA INSURANCE COMPANY | $4K | — | $4K | 6.79% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNITED CONCORDIA INSURANCE COMPANY | $1K | — | $1K | 2.00% |
| RONALD HUPERT3 | 1700 N BROADWAY, STE 380 WALNUT CREEK, CA 94596 | UNITED CONCORDIA INSURANCE COMPANY | $282 | — | $282 | 0.50% |
| JACK NOVICIO INSURANCE AGENCY INC3 Filed as: JACK-NOVICIO INSURANCE AGEANCY INC | 2745 CROSBY WAY SACRAMENTO, CA 95815 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 11.83% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | HUMANA INSURANCE COMPANY | -$17 | — | -$17 | -0.05% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 60 | $458K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 60 | $56K |
| Vision | HUMANA INSURANCE COMPANY | 138 | $34K |
| Life insurance | HUMANA INSURANCE COMPANY | 138 | $34K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 60 | $458K |
| Other | HUMANA INSURANCE COMPANY | 138 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.