| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FULLERTON INSURANCE SERVICES I3 Filed as: FULLERTON INSURANCE SERVICE, INC. | 1551 N TUSTIN AVE STE 500 SANTA ANA, CA 927058690 | KAISER FOUNDATION HEALTH PLAN INC | $23K | — | $23K | 2.24% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 3470 MT DIABLO BLVD STE A100 LAFAYETTE, CA 945493958 | KAISER FOUNDATION HEALTH PLAN INC | $18K | $3 | $18K | 1.79% |
| FULLERTON INSURANCE SERVICE IN3 | 1009 S PLACENTIA AVE FULLERTON, CA 92831 | BLUE SHIELD OF CALIFORNIA | $32K | — | $32K | 4.17% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $16K | — | $16K | 2.08% |
| FULLERTON INSURANCE SERVICES I3 Filed as: FULLERTON INSURANCE SERVICE, INC. | PO BOX 4054 FULLERTON, CA 92834 | PREMIER ACCESS INSURANCE COMPANY | $6K | — | $6K | 6.78% |
| AMWINS3 Filed as: LISI, INC. | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | PREMIER ACCESS INSURANCE COMPANY | $4K | — | $4K | 4.62% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE | 2300 CONTRA COSTA BLVD STE 600 PLEASANT HILL, CA 94523 | PREMIER ACCESS INSURANCE COMPANY | $530 | — | $530 | 0.62% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC | SUITE A100 3470 MT. DIABLE BLVD. LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $161 | $9K | 15.28% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | STE 600 2300 CONTRA COSTA BLVD PLEASANT HILL, CA 94523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.30% |
| FULLERTON INSURANCE SERVICES I3 Filed as: FULLERTON INSURANCE SERVICE | 1551 N. TUSTIN AVE STE 500 SANTA ANA, CA 92705 | VSP | $1K | — | $1K | 6.16% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | 2300 CONTRA COSTA BLVD STE 600 PLEASANT HILL, CA 94523 | VSP | $854 | — | $854 | 3.84% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC. | STE 600 2300 CONTRA COSTA BLVD PLEASANT HILL, CA 94523 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 16.65% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC | STE 600 2300 CONTRA COSTA BLVD PLEASANT HILL, CA 94523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $49 | $3K | 15.29% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC | SUITE A100 3470 MT. DIABLE BLVD. LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $37 | $1K | 10.30% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC | STE 600 2300 CONTRA COSTA BLVD PLEASANT HILL, CA 94523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $29 | $2K | 15.29% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 174 | $1.8M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 265 | $86K |
| Vision | VSP | 132 | $22K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $88K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 42 | $10K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 53 | $17K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 145 | $774K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.