| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE COMPANY | $75K | $0 | $75K | 4.10% |
| DESIGNED PROTECTION INSURANCE SVCS3 | 150 NORTH SAN DIMAS AVENUE #201 SAN DIMAS, CA 91773 | KAISER FOUNDATION HEALTH PLAN | $13K | $0 | $13K | 5.44% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | $5K | $28K | 13.32% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 2.73% |
| DESIGNED PROTECTION INSURANCE SVCS3 | 150 NORTH SAN DIMAS AVENUE #201 SAN DIMAS, CA 91773 | KAISER FOUNDATION HEALTH PLAN | $4K | $0 | $4K | 5.43% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | 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)(3 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 171 | $2.2M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $210K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $210K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $210K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $210K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $210K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.