| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMY K KISTLER3 | 5787 WEST NORWICH FRESNO, CA 93722 | BLUECROSS OF CALIFORNIA | $35K | — | $35K | 5.79% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 6200 CANOGA AVE SUITE 300 WOODLAND HILLS, CA 91367 | BLUECROSS OF CALIFORNIA | $13K | — | $13K | 2.15% |
| AMY KISTLER3 Filed as: AMY KATRIN KISTLER | 12220 58TH AVE NW GIG HARBOR, WA 98332 | BLUECROSS BLUESHIELD OF TENNESSEE | $18K | — | $18K | 5.03% |
| AMY KISTLER3 | 4924 CANTERWOOD DR NW GIG HARBOR, CA 98332 | KAISER FOUNDATION | $12K | — | $12K | 4.90% |
| AMY K KISTLER3 | 5787 WEST NORWICH FRESNO, CA 93722 | BLUESHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $190 | — | $190 | 5.00% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 6200 CANOGA AVE SUITE 300 WOODLAND HILLS, CA 91367 | BLUESHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $77 | — | $77 | 2.03% |
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 | 176 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUECROSS OF CALIFORNIA | 177 | $1.2M |
| Life insurance | BLUESHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 68 | $4K |
| Prescription drug | BLUECROSS OF CALIFORNIA | 177 | $599K |
| Other | BLUESHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 68 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.