| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | $15K | — | $15K | 1.89% |
| LOCKTON COMPANIES, LLC3 | 725 S. FIGUEROA STREET, FLOOR 35 LOS ANGELES, CA 900175435 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.81% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 606731298 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 1.86% |
| LOCKTON COMPANIES, LLC3 | 725 S. FIGUEROA STREET, FLOOR 35 LOS ANGELES, CA 900175435 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 0.84% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON, LLC | P.O. BOX 29018 PORTLAND, OR 972969018 | KAISER FOUNDATION HEALTH PLAN INC. | $24 | — | $24 | 0.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | 29840 NETWORK PLACE CHICAGO, IL 606730001 | PRINCIPAL LIFE INSURANCE COMPANY | $26K | — | $26K | 3.83% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S. FIGUEROA STREET, FLOOR 35 LOS ANGELES, CA 900175435 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | — | $12K | 1.71% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | P.O. BOX 29018 PORTLAND, OR 972969018 | PRINCIPAL LIFE INSURANCE COMPANY | $19 | — | $19 | 0.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | P.O. BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $5K | — | $5K | 4.11% |
| LOCKTON COMPANIES, LLC3 | TWO EMBARCADERO CENTER, SUITE 1700 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $1K | — | $1K | 0.82% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | 29840 NETWORK PLACE CHICAGO, IL 60673 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 6.68% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $627 | $4K | 6.41% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON LLC | P.O BOX 29018 PORTLAND, OR 97296 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $157 | $3K | 3.68% |
| BENJAMIN ACEVEDO3 | 16211 E. GROVECENTER STREET COVINA, CA 91722 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $95 | $2K | 2.37% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $305 | $1K | 2.05% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 W. 187TH PLACE TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $829 | $177 | $1K | 1.46% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INSURANCE SERVICES | P.O. BOX 905494 CHARLOTTE, NC 28290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $724 | — | $724 | 1.05% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLAS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $408 | $15 | $423 | 0.62% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $329 | $3 | $332 | 0.48% |
| SADIE BLACKMON3 | 627 RAPIDS ROAD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 0.19% |
| CENTENNIAL GROUP BENEFITS INSURANCE3 Filed as: CENTENNIAL GROUP BENEFITS & INS. | P.O. BOX 26457 SANTA ANA, CA 92799 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | — | $117 | 0.17% |
| RITA J ROBINSON3 Filed as: RITA J. ROBINSON | 7140 SOUTH WEST FRI LOOP PORTLAND, OR 97223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $5 | $108 | 0.16% |
| MARY ESTHER TAYLOR3 | 1126 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | — | $103 | 0.15% |
| ALLYN INCORPORATED3 | 14813 SEMINOLE TRAIL SEMINOLE, FL 33776 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.07% |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 32101 FALL RIVER ROAD TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.05% |
| VOLUNTARY BENEFITS ADVISORY NETWORK3 | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.04% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.03% |
| DANA MARIE MOWATT3 Filed as: DANA MORIE MOWATT | 23701 S. WESTERN AVE., SUITE 112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.02% |
| PAMELA KAY LONG3 | 200 S. LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| CHAD L FRAZIER3 Filed as: CHAD L. FRAZIER | 1151 SOUZA WAY FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| ANN ASCANI3 | 2809 WINDING TRAIL DRIVE VALRICO, FL 33596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $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 | 1,297 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 197 | $1.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 2,545 | $689K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 1,918 | $112K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 2,545 | $689K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 77 | $69K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 2,545 | $689K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,545 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.