| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 WEST MACARTHUR, SUITE 320 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC. | $377K | $19K | $396K | 2.11% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 WEST MACARTHUR, SUITE 320 SANTA ANA, CA 92704 | HEALTH NET | $232K | $0 | $232K | 1.91% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 WEST MACARTHUR, SUITE 320 SANTA ANA, CA 92704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $315K | $296K | $611K | 11.25% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $133K | $133K | 2.44% |
| THOMAS EDWARD BRADBURY3 | 35 BLUE HERON DRIVE FLETCHER, NC 28732 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 0.09% |
| DJ MCCLUSKEY INC3 | 39500 HIGH POINTE BOULEVARD SUITE 400 NOVI, MI 48375 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $799 | $0 | $799 | 0.01% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 WEST MACARTHUR, SUITE 320 SANTA ANA, CA 92704 | AETNA LIFE INSURANCE COMPANY | $826K | $65 | $826K | 18.24% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 575 ANTON BOULEVARD, SUITE 610 COSTA MESA, CA 92626 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $8K | $0 | $8K | 2.01% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 WEST MACARTHUR, SUITE 320 SANTA ANA, CA 92704 | COMPANION LIFE INSURANCE COMPANY | $4K | $3K | $7K | 16.27% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | COMPANION LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.86% |
| CLEVIDENCE INSURANCE SERVICES INC3 | 3000 WEST MACARTHUR, SUITE 320 SANTA ANA, CA 92704 | MUTUAL OF OMAHA INSURANCE COMPANY | $5K | $21K | $25K | 59.69% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $1K | $1K | 3.03% |
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 | 8,764 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,291 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,055 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 3,672 | $30.9M |
| Dental | AETNA LIFE INSURANCE COMPANY | 13,861 | $4.5M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 11,625 | $412K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8,653 | $5.5M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8,653 | $5.4M |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8,653 | $5.5M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 3,672 | $30.9M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8,653 | $5.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,861 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.