| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | — | $28K | 5.99% |
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 CULVER CITY, CA 90230 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 10.00% |
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 CULVER CITY, CA 90230 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 9.93% |
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $824 | — | $824 | 10.00% |
| MICHAEL HAND3 | 100 CORPORATE POINT, SUITE 210 CULVER CITY, CA 90230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $659 | — | $659 | 10.01% |
| D'ANN DABELL3 | 1174 N 2000 E LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $360 | — | $360 | 9.11% |
| DON R. WILSON3 Filed as: DON WILSON | 146 RAINBOW DRIVE LIVINGSTON, TX 77399 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $334 | — | $334 | 8.45% |
| ROCK WACH3 | 3248 W HANOVER PARK DRIVE SALT LAKE CITY, UT 84119 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $24 | — | $24 | 0.61% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 86 | $461K |
| Dental | DELTA DENTAL OF CALIFORNIA | 121 | $116K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 110 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $7K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 44 | $22K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 49 | $17K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 86 | $461K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.