| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 3655 NOBEL DRIVE, SUITE 450 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 4.02% |
| LOCKTON COMPANIES, LLC3 | UNKNOWN SAN DIEGO, CA 92121 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$4 | -$1 | -$5 | -0.01% |
| LOCKTON COMPANIES, LLC3 | ONE INTERNATIONAL PLACE, 16TH FLOOR BOSTON, MA 02110 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 10.00% |
| JACQUELINE B TIFFER3 Filed as: JACQUELINE TIFFER AND OTHER AGENTS | 15225 SW 140TH STREET MIAMI, FL 33196 | AFLAC | $364 | $0 | $364 | 4.46% |
| SHEILA HALBROOKS3 Filed as: SHEILA L. HALBROOKS | 3686 NW 111TH AVENUE SUNRISE, FL 33351 | AFLAC | $230 | $0 | $230 | 2.82% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | AFLAC | $165 | $0 | $165 | 2.02% |
| LAUREN SMITH INSURANCE SERVICES INC3 Filed as: LAUREN SMITH INSURANCE SERVICES | 4428 ARIZONA STREET, APARTMENT 7 SAN DIEGO, CA 92116 | AFLAC | $75 | $0 | $75 | 0.92% |
| JANET IBANEZ3 | 10205 SW 130TH LANE MIAMI, FL 33176 | AFLAC | $71 | $0 | $71 | 0.87% |
| JOHN H VRATSINAS3 Filed as: JOHN H. VRATSINAS | 2821 NORTH OCEAN BOUELVARD APARTMENT 305 FORT LAUDERDALE, FL 33308 | AFLAC | $39 | $0 | $39 | 0.48% |
| PCS INSURANCE SERVICES INC3 Filed as: PCS INSURANCE SERVICES, INC. | 2553 27TH STREET, APARTMENT A SACRAMENTO, CA 95818 | AFLAC | $38 | $0 | $38 | 0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY ROAD SAN DIEGO, CA 92121 | AETNA LIFE INSURANCE COMPANY | $299 | $0 | $299 | 7.07% |
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 | 404 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 170 | $78K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 940 | $46K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 940 | $38K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 432 | $27K |
| Short-term disability | AFLAC | 110 | $8K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 432 | $27K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 170 | $74K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 940 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 940 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.