| 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 | $63K | — | $63K | 7.76% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | INC. 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 2.12% |
| ALEX THOR FERNANDEZ DBA AXIS3 | INSURANCE AGENCY 18430 BROOKHURST ST #202B FOUNTAIN VALLEY, CA 927086757 | HEALTH NET | $11K | — | $11K | 6.99% |
| TABELLO INS SERVICES INC3 | 1461 SIERRA VISTA DR LA HABRA, CA 90631 | AFLAC | $2K | — | $2K | 4.03% |
| DANIEL J TABELLO3 | 16330 HEATHFIELD DR WHITTIER, CA 90603 | AFLAC | $2K | — | $2K | 3.70% |
| JONATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DR CYPRESS, CA 90630 | AFLAC | $789 | — | $789 | 1.79% |
| AURELIO VELA INSURANCE SERVICES INC3 | 11721 WHITTIER BLVD # 472 WHITTIER, CA 90601 | AFLAC | $525 | — | $525 | 1.19% |
| ELENA MARIA VIERA3 | 10619 PLANETT AVE DOWNEY, CA 90241 | AFLAC | $350 | — | $350 | 0.80% |
| OLIVER SCHACK3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $13 | — | $13 | 0.03% |
| 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 | $972 | — | $972 | 10.05% |
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 | 136 | 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) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 155 | $967K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 255 | $316K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 255 | $306K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 255 | $199K |
| Short-term disability | AFLAC | 45 | $44K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 255 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.