| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $55K | $55K | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $51K | — | $51K | 1.89% |
| GARNETT-POWERS & ASSOCIATION INS3 Filed as: GARNETT-POWERS | 23361 MADERO MISSION VIEJO, CA 92691 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | — | $18K | 2.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $6K | — | $6K | 3.15% |
| GARNETT-POWERS & ASSOCIATION INS Filed as: GARNETT-POWERS | 23361 MADERO MISSION VIEJO, CA 92691 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 1.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 6.51% |
| GARNETT-POWERS & ASSOCIATION INS3 Filed as: GARNETT-POWERS | 23361 MADERO MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.49% |
| MARY ANN LORENZO3 | 737 BISHOP STREET HONOLULU, HI 96813 | HAWAII MEDICAL ASSURANCE ASSOCIATION | $921 | — | $921 | 2.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEAC, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.35% |
| GARNETT-POWERS & ASSOCIATION INS3 Filed as: GARNETT-POERS | 23361 MADERO MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.20% |
| GARNETT-POWERS & ASSOCIATION INS3 Filed as: GARNETT-POWERS | 23361 MADERO MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $621 | — | $621 | 6.20% |
| GARNETT-POWERS & ASSOCIATION INS3 Filed as: GARNETT-POWERS | 23361 MADERO MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $381 | — | $381 | 3.80% |
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 | 506 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 507 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 499 | $3.5M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 499 | $3.0M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 499 | $2.8M |
| Life insurance(3 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 506 | $71K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $48K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $29K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 499 | $3.5M |
| Other(3 contracts, 2 carriers) | HAWAII MEDICAL ASSURANCE ASSOCIATION | 506 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 506 | — |
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.