| 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 | 5.79% |
| 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 | 1.55% |
| ALEX THOR FERNANDEZ DBA AXIS3 | INSURANCE AGENCY 18430 BROOKHURST ST #202B FOUNTAIN VALLEY, CA 927086757 | HEALTH NET | $13K | — | $13K | 6.99% |
| TABELLO INS SERVICES INC3 | 1461 SIERRA VISTA DR LA HABRA, CA 90631 | AFLAC | $2K | — | $2K | 5.70% |
| JONATHAN ALI HAJIMOMEN3 | 6540 GRAND MANAN DR CYPRESS, CA 90630 | AFLAC | $703 | — | $703 | 1.76% |
| DANIEL J TABELLO3 | 16330 HEATHFIELD DR WHITTIER, CA 90603 | AFLAC | $646 | — | $646 | 1.62% |
| AURELIO VELA INSURANCE SERVICES INC3 | 7602 SORENSEN AVE WHITTIER, CA 90606 | AFLAC | $302 | — | $302 | 0.76% |
| ELENA MARIA VIERA3 | 10619 PLANETT AVE DOWNEY, CA 90241 | AFLAC | $301 | — | $301 | 0.75% |
| MARIA R. QUINTANA3 Filed as: MARIA R QUINTANA | 911 S WEBSTER AVE APT 7 ANAHEIM, CA 92804 | AFLAC | $214 | — | $214 | 0.54% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD SANTA ANA, CA 92704 | AFLAC | $4 | — | $4 | 0.01% |
| OLIVER SCHACK3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $2 | — | $2 | 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 | 9.88% |
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 | 149 | 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) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 151 | $1.3M |
| Dental(3 contracts, 3 carriers) | HEALTH NET | 262 | $340K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 262 | $329K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 262 | $188K |
| Short-term disability | AFLAC | 41 | $40K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 262 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.