| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $42K | $0 | $42K | 3.98% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPECTRUM RISK MGMT & INS. SVCS. LLC | 74 DISCOVERY IRVINE, CA 92618 | KAISER FOUNDATION HEALTH PLAN INC | $35K | $0 | $35K | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | BLUE CROSS BLUE SHIELD OF ARIZONA | $8K | $0 | $8K | 2.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 1.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $698 | $698 | 0.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $8K | $22K | 15.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | $1K | $18K | 15.94% |
| MJ INSURANCE3 Filed as: DERECK NICHOLSON AND VARIOUS AGENTS | 18601 NEWLAND STREET, SPACE 56 HUNTINGTON BEACH, CA 92646 | AFLAC | $3K | $341 | $4K | 3.82% |
| SHARI BOYCE3 | 12230 WINDCHIME PLACE APARTMENT E EASTVALE, CA 91752 | AFLAC | $3K | $399 | $3K | 3.21% |
| JOY E GUNDERSON3 Filed as: JOY GUNDERSON | 4531 VALLENCITO LANE YORBA LINDA, CA 92886 | AFLAC | $2K | $109 | $3K | 2.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2K | $0 | $2K | 2.49% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN HAJIMOMEN | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $1K | $131 | $1K | 1.28% |
| CHRISTOPHER L. TANG3 Filed as: CHRISTOPHER TANG | 15155 LEFFINGWELL ROAD WHITTIER, CA 90604 | AFLAC | $1K | $0 | $1K | 1.18% |
| G SCOTT COOKE3 | 2832 NE 17TH AVENUE WILTON MANORS, FL 33334 | AFLAC | $1K | $0 | $1K | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN GARDEN GROVE, CA 92843 | BLUE CROSS BLUE SHIELD OF TEXAS | $2K | $75 | $2K | 4.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $2K | $0 | $2K | 10.39% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SPECTRUM RISK MGMT & INS. SVCS. LLC | 74 DISCOVERY IRVINE, CA 92618 | AMERITAS LIFE INSURANCE CORP. | $291 | $0 | $291 | 10.01% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 228 | $2.4M |
| Dental(4 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 159 | $324K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 238 | $27K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 130 | $205K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 130 | $205K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 130 | $113K |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 228 | $2.3M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 130 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.