| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS, INC. | 1520 BRIDGEWATER DRIVE DIAMOND BAR, CA 91765 | AETNA HEALTH OF CALIFORNIA, INC. | $19K | $0 | $19K | 3.72% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA HEALTH OF CALIFORNIA, INC. | $7K | $0 | $7K | 1.46% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | AETNA HEALTH OF CALIFORNIA, INC. | $5K | $0 | $5K | 0.93% |
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS, INC. | 1520 BRIDGEWATER DRIVE DIAMOND BAR, CA 91765 | AETNA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 5.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 2.95% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | AETNA LIFE INSURANCE COMPANY | $638 | $0 | $638 | 0.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA HEALTH OF CALIFORNIA, INC. | $3K | $0 | $3K | 2.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.66% |
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS, INC. | 1520 BRIDGEGATE DRIVE, SUITE 108 DIAMOND BAR, CA 91765 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 13.63% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3 POLARIS WAY, 4TH FLOOR ALISO VIEJO, CA 92656 | SUN LIFE ASSURANCE COMPANY OF CANADA | $645 | — | $645 | 4.30% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 527 | $888K |
| Dental(2 contracts) | AETNA LIFE INSURANCE COMPANY | 527 | $251K |
| Vision(2 contracts) | AETNA LIFE INSURANCE COMPANY | 527 | $251K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 58 | $15K |
| Prescription drug(4 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 527 | $888K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 58 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 527 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.