| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LBL INSURANCE SERVICES INC3 | 3631 S HARBOR DRIVE SUITE 200 SANTA ANA, CA 92704 | AETNA | $30K | — | $30K | 4.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA LBL INSURANCE SERVICES LLC 3631 S HARBOR DRIVE, SUITE 200 SANTA ANA, CA 92704 | AETNA | $3K | — | $3K | 0.46% |
| LBL INSURANCE SERVICES INC3 | 3631 S HARBOR BLVD SUITE 200 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 3.73% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3631 S HARBOR BLVD SUITE 200 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.22% |
| LBL INSURANCE SERVICES INC3 Filed as: LBL INSURANCE SERVICES | 3631 S HARBOR BLVD SUITE 200 SANTA ANA, CA 92704 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 10.00% |
| LARRY MAX LAMBERT3 | 3631 S HARBOR BLVD SUITE 200 SANTA ANA, CA 92704 | PRINCIPAL LIFE INSURANCE COMPANY | $402 | — | $402 | 10.01% |
| LEBHERZ INSURANCE SERVICES INC3 | 1600W HILLSDALE BLVD SAN MATEO, CA 94402 | PRINCIPAL LIFE INSURANCE COMPANY | $201 | $10 | $211 | 5.26% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA | 108 | $790K |
| Dental | DELTA DENTAL OF CALIFORNIA | 169 | $32K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 58 | $4K |
| Prescription drug(2 contracts, 2 carriers) | AETNA | 108 | $790K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.