| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDMONDS INSURANCE SERVICES, INC.3 | 126 LOMITA STREET EL SEGUNDO, CA 90245 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | $0 | $14K | 3.99% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER CENTER INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | $0 | $6K | 1.80% |
| VERED JUSTIN3 | 17061 EMPANADA PLACE ENCINO, CA 91436 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 0.55% |
| EDMONDS INSURANCE SERVICES, INC.3 | 126 LOMITA STREET EL SEGUNDO, CA 90245 | HEALTH NET | $10K | $0 | $10K | 5.01% |
| VERED JUSTIN3 | 17061 EMPANADA PLACE ENCINO, CA 91436 | HEALTH NET | $4K | $0 | $4K | 1.83% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $7K | $7K | 8.03% |
| EDMONDS INSURANCE SERVICES, INC.3 | 126 LOMITA STREET EL SEGUNDO, CA 90245 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.59% |
| VERED JUSTIN3 | 16501 VENTURA BOULEVARD, SUITE 400 ENCINO, CA 91436 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.17% |
| GARY ALFRED JOHNSON3 | 6709 LA TIJERA BOULEVARD, PMB 926 LOS ANGELES, CA 90045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 12.50% |
| VERED JUSTIN3 | 17061 EMPANADA PLACE ENCINO, CA 91436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 6.18% |
| JACK ALLEN NORRIS3 Filed as: JACK WU | 821 BURLINGTON STREET FILLMORE, CA 93015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $337 | $0 | $337 | 0.49% |
| ABRAMS MARKETING INC3 | 9538 WEST PICO BOULEVARD, SUITE 204 LOS ANGELES, CA 90035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.03% |
| TERI ROLLIN3 | C/O TERI ROLLIN OAK PARK, CA 91377 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN & ASSOCIATES INC | 9795 GATEWAY DRIVE RENO, NV 89521 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 77 | $554K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 141 | $88K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 141 | $88K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 141 | $88K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 56 | $68K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 56 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.