| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KCAL HEALTH INSURANCE SERVICES3 | 2048 S. HACIENDA BOULEVARD HACIENDA HEIGHTS, CA 917454240 | UNITED HEALTHCARE INSURANCE COMPANY | $42K | — | $42K | 4.59% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS LLC | 1600 W. HILLSDALE BLVD., SUITE 201 SAN MATEO, CA 944023766 | UNITED HEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 1.14% |
| ENROLLEASE3 Filed as: DIGITAL BENEFIT ADVISORS- WSTLK VLG | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED HEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 1.11% |
| KCAL HEALTH INSURANCE SERVICES3 | 2128 S. HACIENDA BOULEVARD HACIENDA HEIGHTS, CA 917454242 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $2K | $5K | 5.56% |
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD, SUITE 201 SAN MATEO, CA 944023766 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 2.15% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 1.30% |
| KCAL HEALTH INSURANCE SERVICES3 | 2148 SOUTH HACIENDA BOULEVARD HACIENDA HEIGHTS, CA 91745 | UNITED HEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 15.54% |
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 | 254 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 651 | $1.0M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 651 | $913K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 651 | $913K |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 285 | $37K |
| Long-term disability | UNITED HEALTHCARE INSURANCE COMPANY | 285 | $37K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 651 | $1.0M |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 285 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.