| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS, INC. | 1052 SPINNAKER RUN COSTA MESA, CA 926274589 | KAISER FOUNDATION HEALTH PLAN, INC. | $99K | — | $99K | 2.96% |
| PALO VERDE INC3 Filed as: PALO VERDE, INC. | 8546 CALLE CARABE ST RANCHO CUCAMONGA, CA 917301909 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 0.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FLOYD BROWN | 7560 CAMINO NORTE RANCHO CUCAMONGA, CA 917301025 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 0.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN INSURANCE | ADMINISTRATORS INC 721 S PARKER ST STE 200 ORANGE, CA 928684772 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 0.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT | ADMINISTRATORS INC 721 S PARKER ST STE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $6K | $7K | 4.30% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | ATTN VIVIAN LEUS 2677 N MAIN ST STE 800 SANTA ANA, CA 927054732 | PRINCIPAL LIFE INSURANCE COMPANY | — | $6K | $6K | 3.82% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS INC | DBA CBC INSURANCE 1052 SPINNAKER RUN COSTA MESA, CA 926274589 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 2.35% |
| JAMES ALAN DILKS3 | 8546 CALLE CARABE ST RCH CUCAMONGA, CA 917301909 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 0.89% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FLOYD LEE BROWN | 7560 CAMINO NORTE RCH CUCAMONGA, CA 917301025 | PRINCIPAL LIFE INSURANCE COMPANY | $526 | — | $526 | 0.32% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS, INC. | 1041 W. 18TH #A108 COSTA MESA, CA 92627 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 7.01% |
| DILKS, JAMES A3 | 255 W FOOTHILL BLVD SUITE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $748 | $748 | $1K | 2.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN, FLOYD L | 255 W FOOTHILL BLVD STE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $754 | — | $754 | 1.51% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS, INC. | 1041 W. 18TH #A108 COSTA MESA, CA 92627 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 14.89% |
| DILKS, JAMES A3 | 255 W FOOTHILL BLVD SUITE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $865 | — | $865 | 2.56% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN, FLOYD L | 255 W FOOTHILL BLVD STE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $830 | — | $830 | 2.45% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS 721 S. PARKER, SUITE 300 ORANGE, CA 92868 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $433 | $433 | 1.28% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS, INC. | 1041 W. 18TH #A108 COSTA MESA, CA 92627 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.02% |
| DILKS, JAMES A3 | 255 W FOOTHILL BLVD SUITE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $392 | — | $392 | 2.49% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN, FLOYD L | 255 W FOOTHILL BLVD STE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $373 | — | $373 | 2.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS 721 S. PARKER, SUITE 300 ORANGE, CA 92868 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $196 | $196 | 1.24% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS, INC. | 1041 W. 18TH #A108 COSTA MESA, CA 92627 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 7.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN, FLOYD L | 255 W FOOTHILL BLVD STE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $373 | — | $373 | 2.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: FLOYD BROWN | 255 W FOOTHILL BLVD #102 UPLAND, CA 91786 | CALIFORNIA DENTAL NETWORK, INC. | $601 | — | $601 | 9.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 721 S PARKER RD #300 ORANGE, CA 92868 | CALIFORNIA DENTAL NETWORK, INC. | $430 | — | $430 | 7.00% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTATNTS INC | 1052 SPINNAKER RUN COSTA MESA, CA 92627 | CALIFORNIA DENTAL NETWORK, INC. | $278 | — | $278 | 4.53% |
| PALO VERDE INC3 | 255 W FOOTHILL BLVD #102 UPLAND, CA 91786 | CALIFORNIA DENTAL NETWORK, INC. | $168 | — | $168 | 2.74% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS INC | 1052 SPINNAKER RUN COSTA MESA, CA 92627 | HUMANADENTAL INSURANCE COMPANY | $520 | — | $520 | 9.98% |
| COAST BENEFIT CONSULTANTS3 Filed as: COAST BENEFIT CONSULTANTS, INC. | 1041 W. 18TH #A108 COSTA MESA, CA 92627 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $416 | — | $416 | 10.53% |
| DILKS, JAMES A3 | 255 W FOOTHILL BLVD SUITE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $88 | — | $88 | 2.23% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN, FLOYD L | 255 W FOOTHILL BLVD STE 102 UPLAND, CA 91786 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $85 | — | $85 | 2.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | ADMINISTRATORS 721 S. PARKER, SUITE 300 ORANGE, CA 92868 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $59 | $59 | 1.49% |
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 | 529 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 25 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 554 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 422 | $3.4M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 275 | $175K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 275 | $164K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 133 | $64K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 6 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3 | $34K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 133 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.