| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC. | 24712 AVONDALE DR. LAGUNA HILLS, CA 92653 | BLUE CROSS OF CALIFORNIA | $295K | — | $295K | 3.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | BLUE CROSS OF CALIFORNIA | $26K | — | $26K | 0.29% |
| PENSION & BENEFIT INSURANCE SERVICE3 Filed as: PENSION AND BENEFIT INS. SVCS, INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $142K | — | $142K | 4.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 1 WORLD FINANCIAL CTR, FL. 621 NEW YORK, NY 10281 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | — | $28K | 0.81% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $347 | $37K | 4.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 1 WORLD FINANCIAL CTR 200 LIBERTY ST, FL. 6 NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $61 | $61 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC | $1K | — | $1K | 0.40% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | SIMNSA | $15K | — | $15K | 5.88% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | SIMNSA | $3K | — | $3K | 1.12% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $705 | $6K | 5.63% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GRP INC. | 5775 E. GLENRIDGE DR., STE 3500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 3.11% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $593 | $5K | 5.64% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP INC. | 5775 E. GLENRIDGE DR., STE 3500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 3.15% |
| JOHN E. GREGORY3 | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 3.26% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $930 | $3K | 6.66% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 13.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36 | — | $36 | 0.16% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $931 | $122 | $1K | 5.65% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GRP INC. | 5775 E. GLENRIDGE DR., STE 3500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $603 | $603 | 3.24% |
| JOHN E. GREGORY3 | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $460 | $460 | 3.00% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 92630 | FIRST UNUM LIFE INSURANCE COMPANY | $61 | $7 | $68 | 4.16% |
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 | 2,023 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 27 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,060 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | BLUE CROSS OF CALIFORNIA | 1,658 | $12.8M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,978 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,187 | $136K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,958 | $112K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 268 | $113K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,529 | $77K |
| Prescription drug(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 1,658 | $12.6M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,023 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,023 | — |
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.