| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OLSON DUNCAN INSURANCE SERVICES INC3 Filed as: OLSON DUNCAN INSURANCE SERVICE | 25550 HAWTHORNE BLVD STE 203 TOR, CA 90505 | CALIFORNIA PHYSICIANS' SERVICE | $20K | — | $20K | 6.62% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS' SERVICE | $8K | — | $8K | 2.76% |
| OLSON DUNCAN INSURANCE SERVICES INC3 Filed as: OLSON DUNCAN INSURANCE SERVICE, | INC. 25550 HAWTHORNE BLVD STE 203 TORRANCE, CA 905056831 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 3.88% |
| AMWINS3 Filed as: LISI INC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 944023766 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.50% |
| OLSON DUNCAN INSURANCE SERVICES INC3 Filed as: OLSON DUNCAN INSURANCE SERVICE | 25550 HAWTHORNE BLVD STE 203 TORRANCE, CA 90505 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $219 | — | $219 | 6.45% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $94 | — | $94 | 2.77% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 59 | $426K |
| Dental | CALIFORNIA PHYSICIANS' SERVICE | 59 | $305K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 59 | $305K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 117 | $3K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 59 | $305K |
| Other | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 117 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.