| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS W BOSTON3 Filed as: THOMAS NIAL | 171 E. THOUSAND OAKS BLVD. SUITE 208 THOUSAND OAKS, CA 91360 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | — | $12K | 3.77% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT C. RASMUSSEN | 171 E. THOUSAND OAKS BLVD. SUITE 208 THOUSAND OAKS, CA 91360 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 1.62% |
| THOMAS MEANS3 Filed as: THOMAS MICHAEL NIAL | 171 EAST THOUSAND OAKS BLVD. SUITE 208 THOUSAND OAKS, CA 91360 | HEALTH NET | $3K | — | $3K | 3.41% |
| ROBERT CARL RASMUSSEN JR3 Filed as: ROBERT CARL RASMUSSEN JR. | 171 E. THOUSAND OAKS BLVD. SUITE 208 THOUSAND OAKS, CA 91360 | HEALTH NET | $1K | — | $1K | 1.46% |
| THOMAS MEANS3 Filed as: THOMAS MICHAEL NIAL | 171 EAST THOUSAND OAKS BLVD. SUITE 208 THOUSAND OAKS, CA 91360 | HEALTH NET | $2K | — | $2K | 19.18% |
| ROBERT CARL RASMUSSEN JR3 Filed as: ROBERT CARL RASMUSSEN JR. | 171 E. THOUSAND OAKS BLVD. SUITE 208 THOUSAND OAKS, CA 91360 | HEALTH NET | $795 | — | $795 | 8.22% |
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 | 128 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 119 | $415K |
| Dental(2 contracts) | HEALTH NET | 12 | $89K |
| Vision(2 contracts) | HEALTH NET | 12 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.