| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $40K | — | $40K | 3.48% |
| DAVID BERLINGER3 | 15374 DICKENS STREET SHERMAN OAKS, CA 91403 | BLUE CROSS OF CALIFORNIA | $15K | — | $15K | 4.49% |
| LOCKTON COMPANIES, LLC3 | 8110 EAST UNION AVENUE, SUITE 700 DENVER, CO 80237 | BLUE CROSS OF CALIFORNIA | $10K | — | $10K | 3.10% |
| FARMERS INSURANCE GROUP3 | 4680 WILSHIRE BOULEVARD LOS ANGELES, CA 90010 | BLUE CROSS OF CALIFORNIA | — | $455 | $455 | 0.14% |
| UNKNOWN3 | UNKNOWN MONTEBELLO, CA 90640 | WESTERN DENTAL | $2K | — | $2K | 5.71% |
| DAVID K. BERLINGER3 | 30961 WEST AGOURA ROAD, SUITE 109 WEST LAKE VILLAGE, CA 91361 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.51% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT C. RASMUSSEN | 171 EAST THOUSAND OAKS BOULEVARD SUITE 208 THOUSAND OAKS, CA 91360 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.51% |
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | VISION SERVICE PLAN | $281 | — | $281 | 5.44% |
| DAVID BERLINGER3 | 171 EAST THOUSAND OAKS BOULEVARD SUITE 208 THOUSAND OAKS, CA 91360 | VISION SERVICE PLAN | $221 | — | $221 | 4.28% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 183 | $1.5M |
| Dental | WESTERN DENTAL | 288 | $38K |
| Vision | VISION SERVICE PLAN | 109 | $5K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 33 | $24K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 183 | $1.5M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 33 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.