| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS INC | 1520 BRIDGEGATE DR STE 108 DIAMOND BAR, CA 91765 | UNITEDHEALTHCARE INSURANCE COMPANY | $55K | — | $55K | 3.81% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | $7K | $22K | 1.54% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 1.49% |
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS INC | ATTN DBA DW INS SRVS 1520 BRIDGEGATE DR STE 168 DIAMOND BAR, CA 91765 | PRINCIPAL LIFE INSURANCE COMPANY | $27K | — | $27K | 9.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 3.76% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | ATTN ACCOUNTING DEPT 32110 AGOURA RD WEST LAKE VLG, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 2.85% |
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS, INC. | 1520 BRIDGEGATE DR STE 108 DIAMOND BAR, CA 91765 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 3.98% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 1.22% |
| COMBINED SERVICES LLC3 Filed as: COMBINED BENEFITS, INC. | 1520 BRIDGEGATE DR STE 108 DIAMOND BAR, CA 91765 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 3.57% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $863 | — | $863 | 1.15% |
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 | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 288 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 235 | $1.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 449 | $289K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 449 | $289K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 449 | $289K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 449 | $289K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 449 | $289K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 449 | — |
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.