| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | — | $17K | $17K | 2.20% |
| ALKEME INSURANCE SERVICES INC3 Filed as: ALKEME INSURANCE SERVICES | 111 CORPORATE DR STE 200 LADERA RANCH, CA 92694 | BLUE CROSS OF CALIFORNIA | $16K | — | $16K | 2.03% |
| HEATH BENEFIT PARTNERS INSURANCE3 Filed as: HEATH BENEFIT PARTNERS | 26522 LA ALAMEDA #130 MISSION VIEJO, CA 92691 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 1.72% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 2200 S MAIN ST STE 600 SALT LAKE CITY, UT 84115 | BLUE CROSS OF CALIFORNIA | $9K | — | $9K | 1.19% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | KAISER FOUNDATION HEALTH PLAN | $2K | — | $2K | 2.30% |
| ALKEME INSURANCE SERVICES INC3 Filed as: ALKEME INSURANCE SERVICES | 111 CORPORATE DR STE 200 LADERA RANCH, CA 92694 | KAISER FOUNDATION HEALTH PLAN | $2K | — | $2K | 1.79% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN | $2K | — | $2K | 1.74% |
| HEATH BENEFIT PARTNERS INSURANCE3 Filed as: HEATH BENEFIT PARTNERS | 26522 LA ALAMEDA STE 130 MISSION VIEJO, CA 92691 | KAISER FOUNDATION HEALTH PLAN | $748 | — | $748 | 0.74% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.47% |
| ALKEME INSURANCE SERVICES INC3 Filed as: ALKEME INSURANCE SERVICES | 26522 LA ALAMEDA STE 130 MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.16% |
| HEATH BENEFIT PARTNERS INSURANCE3 Filed as: HEATH BENEFIT PARTNERS | 26522 LA ALAMEDA STE 130 MISSION VIEJO, CA 92691 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $956 | — | $956 | 1.38% |
| ALKEME INSURANCE SERVICES INC3 Filed as: ALKEME INSURANCE | 26522 LA ALAMEDA STE 130 MISION VIEJO, CA 92691 | VISION SERVICES PLAN | $599 | — | $599 | 4.29% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | VISION SERVICES PLAN | $253 | — | $253 | 1.81% |
| HEATH BENEFIT PARTNERS INSURANCE3 Filed as: HEATH BENEFIT PARTNERS | 26522 LA ALAMEDA STE 130 MISION VIEJO, CA 92691 | VISION SERVICES PLAN | $108 | — | $108 | 0.77% |
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 | 134 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 93 | $880K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $69K |
| Vision(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $83K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $69K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.