| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER - IRVINE | PO BOX 95287 CHICAGO, IL 606945287 | KAISER FOUNDATION HEALTH PLAN INC | — | $13K | $13K | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER - IRVINE | PO BOX 95287 CHICAGO, IL 606945287 | KAISER FOUNDATION HEALTH PLAN INC | — | $6K | $6K | 0.28% |
| BENEFITS AMERICA INSURANCE SERVICE4 | 1800 QUAIL STREET #110 NEWPORT BEACH, CA 92660 | GUARDIAN | $10K | $1K | $12K | 5.64% |
| NONE | — | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | RELIANCE LIFE INSURANCE COMPANY | — | $377 | $377 | 1.41% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | RELIANCE LIFE INSURANCE COMPANY | — | $214 | $214 | 1.73% |
| VENBROOK INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | RELIANCE LIFE INSURANCE COMPANY | — | $1 | $1 | 1.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MVI ADMINISTRATORS INSURANCE INC. EIN 33-0393692 NONE | Plan Administrator Service code 14 | — | $337K |
| VENRBOOK INSURANCE SERVICES EIN 20-5817561 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | — | $225K |
| INSURANCE OFFICE OF AMERICA, INC. EIN 59-2472656 NONE | Insurance agents and brokers Service code 22 | — | $72K |
| HUB INTERNATIONAL INSURANCE SERVICE EIN 33-0315047 NONE | Insurance agents and brokers Service code 22 | — | $22K |
| ACRISURE LLC DBA BEAL INSURANCE EIN 59-2472656 NONE | Insurance agents and brokers Service code 22 | — | $18K |
| RBTK, LLP EIN 33-0567239 NONE | Direct payment from the plan Service code 50 | — | $18K |
| LAQUER, URBAN, CLIFFORD & HODGE LLP EIN 95-4047729 NONE | Legal Service code 29 | — | $10K |
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 | 1,613 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,613 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 817 | $7.5M |
| Dental | GUARDIAN | 537 | $208K |
| Vision | VISION SERVICE PLAN | 471 | $44K |
| Life insurance | RELIANCE LIFE INSURANCE COMPANY | 249 | $27K |
| Other(3 contracts) | RELIANCE LIFE INSURANCE COMPANY | 249 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 817 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.