| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 6255 SUDBURY DRIVE DALLAS, TX 75214 | HARTFORD LIFE AND ACCIDENT | — | $33K | $33K | 1.56% |
| HUMANOMICS3 Filed as: HUMANOMICS INSURANCE SERVICES INC | 15600 DEVONSHIRE ST STE 203 GRANADA HILLS, CA 913447242 | KAISER FOUNDATION HEALTH PLAN INC | $69K | — | $69K | 4.02% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 951126371 | KAISER FOUNDATION HEALTH PLAN INC | $17K | $1 | $17K | 0.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: SHIRLEY BROWN | 15600 DEVONSHIRE ST #203 03 GRANADA HILLS, CA 91344 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $45K | — | $45K | 3.50% |
| HUMANOMICS3 Filed as: HUMANOMICS INS SERVICES INC | 15600 DEVONSHIRE ST #203 03 GRANADA HILLS, CA 91344 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $0 | $27K | $27K | 2.05% |
| HUMANOMICS3 Filed as: HUMANOMICS INSURANCE SERVICES | 15600 DEVONSHIRE ST SUITE 203 GRANDA HILLS, CA 913447242 | METLIFE INSURANCE COMPANY | $67K | — | $67K | 8.06% |
| CRAIG HASENBANK3 | 18403 COLLINS ST UNIT C TARZANA, CA 913566504 | METLIFE INSURANCE COMPANY | $57K | — | $57K | 6.88% |
| ALEXANDRA HASENBANK3 | 18403 COLLINS ST UNIT C TARZANA, CA 913566504 | METLIFE INSURANCE COMPANY | $34K | — | $34K | 4.10% |
| BRIAN W PATTEN3 Filed as: BRIAN WILLIAM PATTEN | 121 BUCKTHORN ROAD BADEN, PA 15005 | METLIFE INSURANCE COMPANY | $3K | — | $3K | 0.40% |
| WILLIE RILEY3 | PO BOX 6836 SAN JOSE, CA 951506836 | METLIFE INSURANCE COMPANY | $2K | — | $2K | 0.27% |
| RENTON PEXA3 | 21529 PARVIN DR SANTA CLARITA, CA 913503010 | METLIFE INSURANCE COMPANY | $1K | — | $1K | 0.13% |
| JUDY PIPKIN3 | PO BOX 6836 SAN JOSE, CA 951506836 | METLIFE INSURANCE COMPANY | $857 | — | $857 | 0.10% |
| PATRICIA ORTEGA3 | 6890 WHEELER CT FONTANA, CA 92336 | METLIFE INSURANCE COMPANY | $248 | — | $248 | 0.03% |
| RICHARD LAMONA3 | 23117 CALVERT ST WOODLAND HIILS, CA 91356 | METLIFE INSURANCE COMPANY | $144 | — | $144 | 0.02% |
| HUMANOMICS3 Filed as: HUMANOMICS INSURANCE SERVICES | 15600 DEVONSHIRE ST STE 203 GRANADA HILLS, CA 913447242 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 3.66% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 951126371 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 1.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MICHIGAN EIN 38-2069753 CONTRACT ADMINISTRATOR | Other fees; Consulting (general); Insurance services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $2.6M |
| BENESYS EIN 38-2383171 THIRD PARTY ADMIN | Direct payment from the plan; Contract Administrator Service code 13 | — | $1.4M |
| BRIAN PATTEN & ASSOCIATES LLC INSURANCE CONSULTANT | Direct payment from the plan; Consulting (general); Insurance agents and brokers Service code 16 | 120 MARGUERITE DRIVE SUITE 100 CRANBERRY TOWNSHIP, PA 16066 | $888K |
| HUMANOMICS EIN 38-3669952 INSURANCE CONSULTANT | Insurance agents and brokers; Direct payment from the plan; Consulting (general) Service code 16 | — | $511K |
| COWDEN ASSOCIATES, INC. EIN 25-1750131 INSURANCE CONSULTANT | Insurance agents and brokers; Direct payment from the plan; Consulting (general) Service code 16 | — | $250K |
| CENKO VENDITTELLI HAYNES AND TOKARZ EIN 81-0584482 ACCOUNTING | Accounting (including auditing); Consulting (general); Direct payment from the plan Service code 10 | — | $176K |
| GREGORY, MOORE JEAKLE & BROOKS PC EIN 38-3093929 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $93K |
| AMERICAN GRAPHICS PRINTING CO. OTHER SERVICES | Other services; Direct payment from the plan Service code 49 | 34895 GROESBECK HWY. CLINTON TWP, MI 48035 | $28K |
| BECKERMAN & COMPANY INSURANCE SERVICES | Direct payment from the plan; Insurance services Service code 23 | 430 LAKE AVE. COLONIA, NJ 07067 | $26K |
| COMERICA BANK TRUSTEE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | PO BOX 75000 DETROIT, MI 482754537 | $17K |
| WESTERN INTERNATIONAL SECURITIES INVESTMENT SERVICES | Investment advisory (plan); Direct payment from the plan Service code 27 | 4510 E THOUSAND OAKS BLVD WEST LAKE VILLAGE, CA 91362 | $15K |
| WAGNER LAW GROUP LEGAL | Legal; Direct payment from the plan Service code 29 | 1015 18TH ST NW SUITE 801 WASHINGTON, DC 20036 | $12K |
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 | 7,092 | 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) | 7,092 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,449 | $2.1M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 4,449 | $2.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 4,449 | $2.1M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MICHIGAN | 4,080 | $1.3M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 4,449 | $4.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,449 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.