| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $62K | — | $62K | 5.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BLVD. GLENDALE, CA 91203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 0.14% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 5.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | — | $1K | $1K | 0.48% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 4.54% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $1K | $6K | 17.99% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE | $1K | — | $1K | 9.98% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $329 | $2K | 18.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $279 | $2K | 18.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $867 | $173 | $1K | 17.99% |
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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $1.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $1.1M |
| Vision | EYEMED VISION CARE | 239 | $11K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 157 | $20K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 23 | $6K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 157 | $35K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 51 | $419K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 157 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.