| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS OF CALIFORNIA INSURANCE SVCS. | 18201 VON KARMAN AVE., SUITE 1020 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | — | $18K | 4.32% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICE | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | — | $11K | 2.83% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | $12 | $7K | 1.77% |
| HAYS COMPANIES, INC.3 Filed as: HAYS OF CALIFORNIA INSURANCE SVCS. | P.O BOX 1414 MINNEAPOLIS, MN 55480 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 6.73% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 5.84% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.29% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 18201 VON KARMAN AVE., SUITE 1020 IRVINE, CA 92612 | CALIFORNIA DENTAL NETWORK, INC. | $743 | — | $743 | 8.13% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | CALIFORNIA DENTAL NETWORK, INC. | $171 | — | $171 | 1.87% |
| HAYS COMPANIES, INC.3 Filed as: HAYS OF CALIFORNIA INSURANCE SVCS. | 18201 VON KARMAN AVE., SUITE 510 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 14.15% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $423 | — | $423 | 5.84% |
| GIS NATIONAL3 Filed as: GIS BENEFITS & INSURANCE SERVICES | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $362 | $39 | $401 | 5.54% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD. BLDG. 1, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $362 | $362 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS OF CALIFORNIA INSURANCE SVCS. | 18201 VON KARMAN AVE., SUITE 510 IRVINE, CA 92612 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $993 | — | $993 | 14.66% |
| GIS NATIONAL3 Filed as: GIS BENEFITS & INSURANCE SERVICES | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $339 | $38 | $377 | 5.57% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $361 | — | $361 | 5.33% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD. BLDG. 1, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $339 | $339 | 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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 111 | $406K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 166 | $87K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 166 | $78K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 166 | $78K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 41 | $7K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 111 | $406K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 166 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.