| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $22K | — | $22K | 3.55% |
| ALLIANT INSURANCE SERVICES, INC.3 | 100 PINE STREET, 11TH FLOOR SAN FRANCISCO, CA 94111 | AETNA HEALTH, INC. | $20K | — | $20K | 3.23% |
| ALLIANT INSURANCE SERVICES, INC.3 | 100 PINE STREET, 11TH FLOOR SAN FANCISCO, CA 94111 | AETNA LIFE INSURANCE COMPANY | $2K | $300 | $2K | 5.35% |
| ALLIANT INSURANCE SERVICES, INC.3 | 570 RANCHEROS DRIVE, SUITE 100 SAN MARCOS, CA 92069 | AETNA LIFE INSURANCE COMPANY | — | $195 | $195 | 0.45% |
| GEORGE MICHAEL SORRENTINO3 | 1123 ALEXANDRIA DRIVE SAN DIEGO, CA 92107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 28.99% |
| BEVERLY BERGTHOLD3 Filed as: BEVERLY BERGTHOLD AND OTHER AGENTS | 1043 NORMINGTON WAY SAN JOSE, CA 95136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $476 | $194 | $670 | 3.37% |
| BELLE NATIONAL BENEFITS LLC3 | 9655 WAUKEGAN AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $378 | $174 | $552 | 2.78% |
| SALVADOR HEREDIA3 | 700 EL CAMINITO LIVERMORE, CA 94550 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $375 | $75 | $450 | 2.26% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DRIVE MURRIETA, CA 92562 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $342 | $71 | $413 | 2.08% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND GONG | 2180 FENTON PARKWAY SAN DIEGO, CA 92108 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $297 | $94 | $391 | 1.97% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $272 | $35 | $307 | 1.54% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 161 | $43K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $11K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.3M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 126 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.