| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SVCS LL3 | 1800 QUAIL ST 110 NEWPORT BEACH, CA 92660 | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | $224K | — | $224K | 5.00% |
| BENEFITS AMERICA INSURANCE SRVS LLC3 | 1800 QUAIL ST 110 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $33K | — | $33K | 5.00% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE FL 12 WOODLAND HILLS, CA 913672584 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 4.75% |
| PRIVILEGE INSURANCE SERVICES, INC.3 | 14451 CHAMBERS RD STE 220 TUSTIN, CA 927806989 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.50% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVE FL 12 WOODLAND HILLS, CA 913672584 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 4.78% |
| PRIVILEGE INSURANCE SERVICES, INC.3 | 14451 CHAMBERS RD STE 220 TUSTIN, CA 927806989 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 0.51% |
| BENEFITS AMERICA INSURANCE SER3 | 11933 FOXBORO DRIVE LOS ANGELES, CA 90049 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 18.86% |
| BENEFITS AMERICA INSURANCE SER3 | 1800 QUAIL ST #110 NEWPORT BEACH, CA 92660 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 16.46% |
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 | 753 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 763 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $5.7M |
| Dental | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $4.5M |
| Vision | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $4.5M |
| Life insurance | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $4.5M |
| Short-term disability | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $4.5M |
| Long-term disability | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $4.5M |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 757 | $1.2M |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE & HEALTH INSURANCE COMPANY | 5,175 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,175 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.