| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 26457 SANTA ANA, CA 92799 | KAISER FOUNDATION HEALTH PLAN INC. | $41K | — | $41K | 4.59% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | 1800 QUAIL ST SUITE 110 NEWPORT BEACH, CA 92660 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 2.10% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | — | $23K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.71% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | — | $13K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.71% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.70% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | 1500 QUAIL STREET, SUITE 100 MAILI NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | $2K | — | $2K | 4.86% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $760 | $760 | 2.75% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $675 | $675 | 2.54% |
| CENTENNIAL GROUP BENEFITS3 Filed as: CENTENNIAL GROUP BENEFITS & INS SVC | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $601 | $601 | 2.43% |
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 | 350 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 124 | $936K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 259 | $319K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $76K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 349 | $152K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 349 | $85K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 124 | $936K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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.