| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | KAISER FOUNDATION HEALTH PLAN INC | $65K | — | $65K | 1.82% |
| UNIFIED GROCERS INSURANCE SERVICES3 | 874 S VILLAGE OAKS DR COVINA, CA 917243614 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 0.18% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED CONCORDIA INSURANCE COMPANY | $54K | — | $54K | 3.67% |
| UNIFIED GROCERS INSURANCE SERVICES3 | 874 S VILLAGE OAKS DR. COVINA, CA 91724 | UNITED CONCORDIA INSURANCE COMPANY | $5K | — | $5K | 0.35% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | SIMNSA | $22K | — | $22K | 2.00% |
| DIRECTPATH, LLC3 | 120 18TH STREET SOUTH SUITE 102 BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $39K | $6K | $45K | 8.19% |
| ENROLLMENT RESOURCES GROUP3 | WILLIS OF ILLINOIS, INC. 233 S. WACKER DRIVE SUITE 2000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $32K | $2K | $34K | 6.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | FILE 50788 LOS ANGELES, CA 90074 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | $1K | $23K | 4.19% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 3281 E GAUSTI RD STE 400 ONTARIO, CA 91761 | SUN LIFE ASSURANCE COMPANY OF CANADA | $43K | — | $43K | 8.30% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS SERVICES INC | 874 S VILLAGE OAKS DR COVINA, CA 91724 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 1.70% |
| UNIFIED GROCERS INSURANCE SERVICES3 | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $7K | — | $7K | 3.65% |
| UNIFIED GROCERS INSURANCE SERVICES3 | 874 S VILLAGE OAKS DR. COVINA, CA 91724 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $709 | — | $709 | 0.39% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 130 VANTIS STE 250 ALISO VIEJO, CA 926562703 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 4.17% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS SERVICES INC | 874 S VILLAGE OAKS DR COVINA, CA 917243614 | STANDARD INSURANCE COMPANY | $399 | — | $399 | 0.41% |
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 | 2,464 | 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) | 2,464 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,045 | $4.7M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 3,208 | $1.7M |
| Vision | STANDARD INSURANCE COMPANY | 2,703 | $97K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,856 | $519K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,856 | $519K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,856 | $519K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,856 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,856 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.