| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS ALLIANCE INSURANCE SERVICE3 | 5210 LEWIS ROAD, SUITE 14 AGOURA HILLS, CA 91356 | AETNA HEALTH, INC. | $27K | — | $27K | 3.06% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | AETNA HEALTH, INC. | $21K | — | $21K | 2.42% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | KAISER PERMANENTE | $16K | — | $16K | 2.55% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 | 5210 LEWIS ROAD, SUITE 14 AGOURA HILLS, CA 91356 | KAISER PERMANENTE | $14K | — | $14K | 2.37% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 | 5210 LEWIS ROAD, SUITE 14 AGOURA HILLS, CA 91301 | GUARDIAN | $3K | $4K | $7K | 7.01% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | GUARDIAN | $882 | — | $882 | 0.93% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 | 5210 LEWIS ROAD, SUITE 14 AGOURA HILLS, CA 91356 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $320 | $2K | 8.48% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY L | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.20% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 | 5210 LEWIS ROAD, SUITE 14 AGOURA HILLS, CA 91356 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $680 | $585 | $1K | 8.37% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $832 | — | $832 | 5.50% |
| COMBINED INSURANCE COMPANY OF AMERI3 Filed as: COMBINED INS CO - SEE ATTACHED | 1000 N MILWAUKEE AVENUE GLENVIEW, IL 60025 | COMBINED INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 36.27% |
| CAMDEN INSURANCE AGENCY3 Filed as: THE CAMDEN INSURANCE AGENCY | 3255 WILSHIRE BLVD, SUITE 1610 LOS ANGELES, CA 90010 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 24.93% |
| INTEGRITY ASSET SERVICES LLC4 | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $230 | — | $230 | 5.85% |
| ANGEL L. STEPHENS4 Filed as: ANGEL L STEPHENS | PO BOX 36114 LOS ANGELES, CA 90036 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $219 | — | $219 | 5.57% |
| IBRAHIM ABDELHADI4 | 4510 W GUADALUPE ST, APT C412 AUSTIN, TX 78751 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $89 | — | $89 | 2.26% |
| W CRAIG HEPNER4 | 27 CLERMONT NEWPORT COAST, CA 92657 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $51 | — | $51 | 1.30% |
| JERRY K. COHEN4 Filed as: JERRY K COHEN | 15720 VENTURA BLVD, SUITE 324 ENCINO, CA 91436 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $29 | — | $29 | 0.74% |
| ALLISON E BERRY4 | 5349 BEAR RUN ROAD LAKESIDE, AZ 85929 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $13 | — | $13 | 0.33% |
| BENEFITS ALLIANCE INSURANCE SERVICE3 | 5210 LEWIS ROAD, SUITE 14 AGOURA HILLS, CA 91356 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $125 | $41 | $166 | 9.20% |
| MARSH & MCLENNAN AGENCY LLC3 | DBA BARNEY BARNEY INS SVCS. 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $146 | — | $146 | 8.09% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 149 | $1.5M |
| Dental | GUARDIAN | 166 | $95K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 37 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $19K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 23 | $15K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 149 | $1.5M |
| Other(3 contracts, 3 carriers) | COMBINED INSURANCE COMPANY OF AMERICA | 198 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.