| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHOMER INSURANCE AGENCY0 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | KAISER FOUNDATION HEALTH PLAN INC | $121K | $0 | $121K | 2.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN INC | $59K | $0 | $59K | 1.45% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 500 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $20K | $0 | $20K | 0.50% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1K | $1K | 0.03% |
| SHOMER INSURANCE AGENCY0 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | KAISER FOUNDATION HEALTH PLAN INC | $22K | $0 | $22K | 4.19% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | METROPOLITAN LIFE INSURANCE COMPANY | $33K | $0 | $33K | 8.58% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD, SUITE 110 PITTSBURGH, PA 15220 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.89% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.70% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $2K | $0 | $2K | 9.88% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD, SUITE 110 PITTSBURGH, PA 15220 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $0 | $348 | $348 | 1.46% |
| SHOMER INSURANCE AGENCY3 Filed as: SHOMER INSURANCE SERVICES, INC. | 5805 SEPULVEDA BOULEVARD, SUITE 500 SHERMAN OAKS, CA 91411 | SAFEGUARD HEALTH PLANS INC., A CALIFORNIA CORPORATION | $0 | $198 | $198 | 0.83% |
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 | 1,500 | 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) | 1,500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 447 | $4.6M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,500 | $403K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,500 | $379K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,500 | $379K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 447 | $4.6M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,500 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,500 | — |
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.