| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRITY ASSOCIATES INS. SERVICES3 Filed as: INTEGRITY ASSOCIATES | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | DELTA DENTAL OF CALIFORNIA | $23K | — | $23K | 2.52% |
| INTEGRITY ASSOCIATES INS. SERVICES3 Filed as: INTEGRITY ASSOCIATES | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | CIGNA HEALTH & LIFE INSURANCE CO. | $97K | — | $97K | 13.55% |
| INTEGRITY ASSOCIATES INS. SERVICES3 | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $27K | — | $27K | 15.00% |
| INTEGRITY ASSOCIATES INS. SERVICES3 | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | — | $16K | 15.00% |
| INTEGRITY ASSOCIATES INS. SERVICES3 | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| INTEGRITY ASSOCIATES INS. SERVICES3 Filed as: INTEGRITY ASSOCIATES INSURANCE | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | VISION SERVICE PLAN | $5K | — | $5K | 10.00% |
| INTEGRITY ASSOCIATES INS. SERVICES3 Filed as: INTEGRITY ASSOCIATES INS. SVCS INC. | P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LANDMARK HEALTHPLAN | $0 | — | $0 | 0.00% |
| KENNETH R. HUBBERT3 | INTEGRITY ASSOCIATES INS. SVCS INC. P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LANDMARK HEALTH PLAN | $0 | — | $0 | 0.00% |
| KENNETH R. HUBBERT3 | INTEGRITY ASSOCIATES INS. SVCS. INC P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LANDMARK HEALTH PLAN | $0 | — | $0 | 0.00% |
| KENNETH R. HUBBERT3 | INTEGRITY ASSOCIATES INS. SVCS. INC P.O. BOX 1006 THOUSAND OAKS, CA 91358 | LANDMARK HEALTHPLAN | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $565K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Participant communication; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $9K |
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 | 464 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH & LIFE INSURANCE CO. | 468 | $736K |
| Dental | DELTA DENTAL OF CALIFORNIA | 462 | $922K |
| Vision | VISION SERVICE PLAN | 463 | $55K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 435 | $178K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 435 | $60K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 435 | $108K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH & LIFE INSURANCE CO. | 468 | $713K |
| Other | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 435 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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.