| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS W BOSTON3 Filed as: THOMAS NIAL | — | CALIFORNIACHOICE | $26K | $0 | $26K | 2.50% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT C RASMUSSEN | — | CALIFORNIACHOICE | $26K | $0 | $26K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS INC | — | CALIFORNIACHOICE | $19K | $0 | $19K | 1.77% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT C RASMUSSEN | 154 SYMPHONY LANE OAK PARK, CA 91377 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 5.00% |
| THOMAS MEANS3 Filed as: THOMAS MICHAEL NIAL | 801 RIM CREST DRIVE WESTLAKE VILLAGE, CA 91361 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 5.00% |
| PACIFIC ADVISORS LLC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $718 | $0 | $718 | 0.75% |
| MICHAEL A OLIVER3 | 8212 MAINSAIL DR UNIT 201 HUNTINGTON BEACH, CA 92646 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $529 | $0 | $529 | 12.54% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS INC | 1550 W COLORADO BLVD PASADENA, CA 91105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $53 | $0 | $53 | 1.26% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 140 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $96K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $96K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $96K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 6 | $4K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 6 | $4K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 157 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.