| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INS. SVCS., LLC3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC | $30K | $0 | $30K | 4.58% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 3.03% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $8K | $0 | $8K | 2.95% |
| BENEFITS AMERICA INS. SVCS., LLC3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.08% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK, LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $227 | $227 | 0.17% |
| MJ INSURANCE3 Filed as: RENEE CORSO AND VARIOUS AGENTS | 5805 SEPULVEDA BOULEVARD, SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $3K | $63 | $3K | 5.83% |
| MICHELLE ANN DERAS3 | 5805 SEPULVEDA BOULEVARD, SUITE 700 SHERMAN OAKS, CA 91411 | AFLAC | $3K | $172 | $3K | 4.63% |
| BETTY MURDOCK3 | 7216 TESSERA PARKWAY LAGO VISTA, TX 78645 | AFLAC | $1K | $43 | $2K | 2.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | 3475 EAST FOOTHILL BOULEVARD PASADENA, CA 91107 | AFLAC | $1K | $0 | $1K | 1.76% |
| RUBEN ROSA3 | 5307 SEPULVEDA BOULEVARD, SUITE 118 SHERMAN OAKS, CA 91411 | AFLAC | $677 | $24 | $701 | 1.18% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | AFLAC | $695 | $0 | $695 | 1.17% |
| STANTON HUNTON3 Filed as: STANTON C. HUNTON | 2516 VIA TEJON, SUITE 307 PALOS VERDES ESTATES, CA 90274 | AFLAC | $632 | $0 | $632 | 1.07% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | CALIFORNIA DENTAL NETWORK, INC. | $771 | $0 | $771 | 10.00% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.4M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 235 | $140K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 235 | $132K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 235 | $132K |
| Short-term disability | AFLAC | 63 | $59K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 235 | $132K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.4M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 235 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.