| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $311K | $0 | $311K | 1.69% |
| ALLIANT INSURANCE SERVICES, INC.3 | 125 HIGH STREET, 22ND FLOOR BOSTON, MA 02110 | BLUE CROSS OF CALIFORNIA | $111K | $0 | $111K | 0.60% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | $86K | $0 | $86K | 1.10% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN, INC. | $43K | $0 | $43K | 0.54% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $0 | $2K | 2.21% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FIOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $0 | $1K | 0.99% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | HARTFORD FIRE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
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 | 1,602 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,623 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 1,824 | $26.5M |
| Vision | VISION SERVICE PLAN | 1,259 | $159K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,602 | $217K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,602 | $217K |
| Prescription drug(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 1,824 | $26.5M |
| Other(3 contracts, 3 carriers) | MODERN HEALTH ARIZONA P.L.L.C. | 1,773 | $494K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,824 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.