| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | KAISER FOUNDATION HEALTH PLAN | $59K | $0 | $59K | 2.20% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | KAISER FOUNDATION HEALTH PLAN | $21K | $0 | $21K | 1.92% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 12.84% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 2.82% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 14.88% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 9.94% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| THE ARK INSURANCE SERVICES, INC.3 | 3740 ELIZABETH STREET RIVERSIDE, CA 925062507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $419 | $0 | $419 | 9.91% |
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 | 488 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN | 471 | $3.8M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 228 | $157K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 211 | $158K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 488 | $90K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 211 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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."
No prospect flags tripped on this filing.