| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | I-801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | BLUE CROSS OF CALIFORNIA | $26K | — | $26K | 4.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 4.88% |
| ANDREINI AND COMPANY3 | 220 WEST TWENTIETH AVENUE SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.97% |
| ANNETTE L. BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $1K | $171 | $1K | 8.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | 801 SOUTH FIGUEROA STREET SUITE 700 LOS ANGELES, CA 90017 | AFLAC | $627 | — | $627 | 3.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS AND OTHER AGENTS | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | AFLAC | $550 | $39 | $589 | 3.59% |
| JACOB BURNS INC.3 Filed as: JACOB M. BURNS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $330 | $42 | $372 | 2.26% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON, JR. | 711 SOUTH OLIVE STREET APARTMENT 314 LOS ANGELES, CA 90014 | AFLAC | $189 | $42 | $231 | 1.41% |
| RENEE COHN3 | 20350 VENTURA BOULEVARD, SUITE 200 WOODLAND HILLS, CA 91364 | AFLAC | $167 | — | $167 | 1.02% |
| KAREN M HUGHES3 Filed as: KAREN M. HUGHES | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $110 | — | $110 | 0.67% |
| BRIAN MILLER3 | 14 WALL STREET, 8TH FLOOR NEW YORK, NY 10005 | AFLAC | $27 | $63 | $90 | 2.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CA AND VARIOUS AGENTS | 801 SOUTH FIGUEROA STREET SUITE 700 LOS ANGELES, CA 90017 | AFLAC | $67 | $17 | $84 | 2.61% |
| MICHAEL BURACK3 | 125 JERICHO TURNPIKE, SUITE 201 JERICHO, NY 11753 | AFLAC | $73 | — | $73 | 2.27% |
| PATRICK RUHLE3 Filed as: PATRICK C. HARDIE | 14 WALL STREET, SUITE 8C NEW YORK, NY 10005 | AFLAC | $35 | $17 | $52 | 1.62% |
| JAMES K FULATER3 Filed as: JAMES K. FULATER | 3052 34TH STREET APARTMENT 2A ASTORIA, NY 11103 | AFLAC | $28 | $23 | $51 | 1.58% |
| STEPHEN WHITE3 Filed as: STEPHEN P. WHITE | 5 EMERALD LANE MONTEBELLO, NY 10901 | AFLAC | $28 | — | $28 | 0.87% |
| BLAINE L. KELLER3 | 320 EAST 54TH STREET APARTMENT 8E NEW YORK, NY 10022 | AFLAC | $25 | — | $25 | 0.78% |
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 | 136 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 201 | $697K |
| Dental | BLUE CROSS OF CALIFORNIA | 201 | $602K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 201 | $602K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 201 | $697K |
| Other(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 201 | $621K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.