| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PENNBROOK INSURANCE SERVICES3 | 300 MONTGOMERY STREET 450 SAN FRANCISCO, CA 94104 | CALIFORNIA PHYSICIANS' SERVICE | $171K | $78 | $171K | 5.00% |
| AMWINS3 Filed as: LISI, INC | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS' SERVICE | $68K | — | $68K | 2.00% |
| PENNBROOK INSURANCE SERVICES3 | 211 GOODHILL ROAD RENTFIELD, CA 94904 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 29.09% |
| PENNBROOK INSURANCE SERVICES3 | 300 MONTGOMERY STREET SUITE 450 SAN FRANCISCO, CA 94104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.38% |
| PENNBROOK INSURANCE SERVICES3 | 300 MONTGOMERY STREET 450 SAN FRANCISCO, CA 94104 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $437 | — | $437 | 4.99% |
| AMWINS3 Filed as: LISI, INC | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $175 | — | $175 | 2.00% |
| PENNBROOK INSURANCE SERVICES3 Filed as: PENNBROOK INSURANCE SERVICES, INC. | 300 MONTGOMERY STREET #450 SAN FRANCISCO, CA 94101 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $171 | — | $171 | 2.86% |
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 | 755 | 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) | 755 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 574 | $3.4M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 568 | $9K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 585 | $176K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 574 | $3.4M |
| Other | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 568 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 585 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.