| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $375K | $0 | $375K | 3.00% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $15K | $0 | $15K | 1.51% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | $0 | $5K | 2.71% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | HARTFORD LIFE AND ACCIDENT INSURANCE CO | $3K | $0 | $3K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | HARTFORD LIFE AND ACCIDENT INSURANCE CO | $0 | $244 | $244 | 1.25% |
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 | 1,638 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,083 | $13.7M |
| Vision | VISION SERVICE PLAN | 1,344 | $169K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,638 | $845K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,638 | $845K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 2,083 | $13.7M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,778 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,083 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.