| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERREMEDY INSURANCE SERVICES Filed as: INTERREMEDY INSURANCE SERVICE, LLC | 315 MONTGOMERY ST STE 900 SAN FRANCISCO, CA 94104 | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | $27K | — | $27K | 6.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SANDRA D. GAMBOA EIN 95-6289239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $157K |
| TINA L. CONNEEN EIN 95-6289239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $105K |
| CARMEN MCKINLEY EIN 95-6289239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $102K |
| SHERRI ANN RUBALCABA EIN 95-6289239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $89K |
| MARY CORONADO EIN 95-6289239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $66K |
| REICH, ADELL & CVITAN EIN 95-3082677 NONE | Legal; Direct payment from the plan Service code 29 | — | $41K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $26K |
| CYNTHIA GRAYDON NONE | Direct payment from the plan; Other services Service code 49 | 1621 BOLERO DR CARSON CITY, NV 89703 | $23K |
| MEDEXPERT INTERNATIONAL INC NONE | Consulting fees; Direct payment from the plan Service code 50 | P.O. BOX 7550 MENLO PARK, CA 94026 | $12K |
| OXFORD RISK MANAGEMENT & INSURANCE EIN 95-1997338 NONE | Direct payment from the plan; Other fees Service code 50 | — | $9K |
| GREEN THUMB LAWN MAINTENANCE NONE | Other services; Direct payment from the plan Service code 49 | 7406 EMERALD ST RIVERSIDE, CA 92504 | $8K |
| OCTOCLEAN FRANCHISING SYSTEMS, INC. NONE | Other services; Direct payment from the plan Service code 49 | 1695 SPRUCE ST STE 100 RIVERSIDE, CA 92507 | $6K |
| EPICOR SOFTWARE CORPORATION EIN 33-0277592 NONE | Direct payment from the plan; Other services Service code 49 | — | $6K |
| KAVORINOS, ANTHONY DDS, APC NONE | Direct payment from the plan; Other fees Service code 50 | 10630 TOWN CENTER DR RANCHO CUCAMONGA, CA 91730 | $5K |
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 | 777 | 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) | 777 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 777 | $396K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 777 | — |
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."
No prospect flags tripped on this filing.