| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAFRIN ASSOCIATES3 | 1507 ROUTE 202 POMONA, NY 10970 | KASIER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 3.23% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 NORTH MAIN STREET SUITE 800 SANTA ANA, CA 92705 | KASIER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 1.68% |
| ECHO NEO NINJA INS SOLUTIONS3 Filed as: ECHO NEO NINJA INSURANCE SOLUTIONS | 4500 PARK GRANADA SUITE 202 CALABASAS, CA 91302 | KASIER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 1.35% |
| DKG INSURANCE AND FINANCIAL SERVICE3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | KASIER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 0.81% |
| SAFRIN ASSOCIATES3 | 1507 ROUTE 202 POMONA, NY 10970 | DELTA | $9K | — | $9K | 6.61% |
| RUSSELL L WARYE3 Filed as: RUSSELL NAKAMURA | 4500 PARK GRANADA BOULEVARD SUITE 202 CALABASAS, CA 91302 | DELTA | $2K | — | $2K | 1.74% |
| DKG INSURANCE & FINANCIAL SERVICES3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | DELTA | $2K | — | $2K | 1.65% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANC | 12404 PARK CENTRAL DRIVE SUITE #400 DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $881 | $881 | 3.61% |
| RUSSELL S NAKAMURA3 | 4500 PARK GRANADA BOULEVARD SUITE 2 CALABASAS, CA 91302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $432 | — | $432 | 1.77% |
| DKG INSURANCE & FINANCIAL SERVICES3 Filed as: DKG INSURANCE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $370 | — | $370 | 1.52% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVI | 5114 POINT FOSDICK DRIVE SUITE F41 GIG HARBOR, WA 98335 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $216 | $216 | 0.89% |
| RUSSELL L WARYE3 Filed as: RUSSELL NAKAMURA | 4500 PARK GRANADA SUITE 202 CALABASAS, CA 91302 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $24K | — | $24K | 138.41% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES L | 2677 NORTH MAIN STREET SANTA ANA, CA 92705 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $19K | $19K | 112.78% |
| JACOB SAFRIN3 | 1507 ROUTE 202 POMONA, NY 10970 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $16K | — | $16K | 93.74% |
| DKG INSURANCE & FINANCIAL SERVICES3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 23.44% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANC | 12404 PARK CENTRAL DRIVE SUITE #400 DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $322 | $322 | 3.45% |
| RUSSELL S NAKAMURA3 | 4500 PARK GRANADA BOULEVARD SUITE 2 CALABASAS, CA 91302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $295 | — | $295 | 3.16% |
| DKG INSURANCE & FINANCIAL SERVICES3 Filed as: DKG INSURANCE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $242 | — | $242 | 2.59% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVI | 5114 POINT FOSDICK DRIVE SUITE F41 GIG HARBOR, WA 98335 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $98 | $98 | 1.05% |
| RUSSELL S NAKAMURA3 | 4500 PARK GRANADA BOULEVARD SUITE 2 CALABASAS, CA 91302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $473 | — | $473 | 7.77% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANC | 12404 PARK CENTRAL DRIVE SUITE #400 DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $384 | $384 | 6.31% |
| AMWINS3 Filed as: AMWINS CONNECT ISURANCE SERVI | 5114 POINT FOSDICK DRIVE SUITE F41 GIG HARBOR, WA 98335 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $164 | $164 | 2.69% |
| DKG INSURANCE & FINANCIAL SERVICES3 Filed as: DKG INSURANCE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $160 | — | $160 | 2.63% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 72 | $1.2M |
| Dental | DELTA | 158 | $130K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 120 | $17K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 56 | $9K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 214 | $24K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 15 | $6K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 56 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.