| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALEX FERNANDEZ D/B/A AXIS INSURANCE3 Filed as: ALEX FERNANDEZ | PO BOX 4064 HUNTINGTON BEACH, CA 926054064 | KAISER FOUNDATION HEALTH PLAN, INC. | $87K | — | $87K | 7.51% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | INC. 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN, INC. | $22K | — | $22K | 1.91% |
| ALEX THOR FERNANDEZ DBA AXIS3 | INSURANCE AGENCY 8464 EL ARROYO DRIVE HUNTINGTON BEACH, CA 92647 | HEALTH NET | $20K | — | $20K | 8.75% |
| TABELLO INS SERVICES INC3 | 1461 SIERRA VISTA DR LA HABRA, CA 90631 | AFLAC | $2K | — | $2K | 3.95% |
| ALEX THOR FERNANDEZ3 | PO BOX 4064 HUNTINGTON BEACH, CA 92605 | AFLAC | $932 | — | $932 | 2.44% |
| JONATHAN ALI HAJIMOMEN3 | 5752 WHISTLER CIR HUNTINGTON BEACH, CA 92649 | AFLAC | $722 | — | $722 | 1.89% |
| LUZ CASTILLO BARRIGA3 Filed as: LUZ C BARRIGA | 22019 JUAN AVE HAWAIIAN GARDENS, CA 90716 | AFLAC | $510 | — | $510 | 1.33% |
| DANIEL J TABELLO3 | 16330 HEATHFIELD DR WHITTIER, CA 90603 | AFLAC | $427 | — | $427 | 1.12% |
| DANIEL TYLER ADAMSON3 | 405 S HIBISCUS WAY ANAHEIM, CA 92808 | AFLAC | $356 | — | $356 | 0.93% |
| AURELIO VELA3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $276 | — | $276 | 0.72% |
| ELENA MARIA VIERA3 | 10619 PLANETT AVE DOWNEY, CA 90241 | AFLAC | $237 | — | $237 | 0.62% |
| GUILLERMO A QUINTERO3 | 18000 STUDEBAKER RD STE 700 CERRITOS, CA 90703 | AFLAC | $51 | — | $51 | 0.13% |
| OLIVER SCHACK3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $22 | — | $22 | 0.06% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD SANTA ANA, CA 92704 | AFLAC | $4 | — | $4 | 0.01% |
| ALEX FERNANDEZ D/B/A AXIS INSURANCE3 | AGENCY PO BOX 4064 HUNTINGTON BEACH, CA 926054064 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | — | $1K | 10.02% |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 163 | $1.4M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $161K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $148K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $186K |
| Short-term disability | AFLAC | 39 | $38K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.