| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | KAISER FOUNDATION HEALTH PLAN INC. | $57K | $677 | $58K | 3.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.07% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.17% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF HOUSTON, LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14 | — | $14 | 0.02% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.20% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $998 | — | $998 | 1.50% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF HOUSTON, LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $860 | — | $860 | 1.29% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | DENTAL HEALTH SERVICES | $3K | — | $3K | 8.60% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | STARMOUNT LIFE INSURANCE COMPANY | $3K | $225 | $3K | 10.75% |
| AMERICORP FINANCIAL PENSION & INS3 | 1964 WESTWOOD BLVD, STE 120 LOS ANGELES, CA 90025 | STARMOUNT LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $128 | $3K | 15.75% |
| AMERICORP FINANCIAL PENSION & INS3 | 1964 WESTWOOD BLVD., SUITE 120 LOS ANGELES, CA 90025 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $852 | — | $852 | 5.00% |
| CAMDEN INSURANCE AGENCY3 | 3255 WILSHIRE BLVD, STE 1610 LOS ANGELES, CA 90010 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $933 | — | $933 | 10.15% |
| ALLIANT INSURANCE SERVICES, INC.3 | 685 EAST CARNEGIE DRIVE, SUITE 265 SAN BERNARDINO, CA 92408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $51 | $1K | 15.75% |
| AMERICORP FINANCIAL PENSION & INS3 | 1964 WESTWOOD BLVD., SUITE 120 LOS ANGELES, CA 90025 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $340 | — | $340 | 5.00% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 292 | $1.9M |
| Dental(2 contracts, 2 carriers) | DENTAL HEALTH SERVICES | 190 | $64K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 159 | $9K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 267 | $91K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 267 | $67K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 292 | $1.9M |
| Other(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 516 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 516 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.