| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | KAISER FOUNDATION HEALTH PLAN INC. | $26K | — | $26K | 5.93% |
| 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 | 2.65% |
| 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. | -$268 | — | -$268 | -0.06% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 8.36% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | CALIFORNIA DENTAL NETWORK, INC. | $1K | — | $1K | 10.00% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| GIS NATIONAL3 Filed as: GIS BENEFITS & INSURANCE SERVICES | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $292 | — | $292 | 5.00% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 19.99% |
| GIS NATIONAL3 Filed as: GIS BENEFITS & INSURANCE SERVICES | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $257 | — | $257 | 4.99% |
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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 112 | $432K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $83K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $71K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $71K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 27 | $6K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 112 | $432K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.