| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GOOD FRIEND INSURANCE SERVICES LLC3 | 3580 WILSHIRE BLVD STE 1510 LOS ANGELES, CA 90010 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $22K | — | $22K | 9.17% |
| AMWINS3 Filed as: AMWINS CONNECT INS SERVICES LLC | 1600 W. HILLSDALE BLVD STE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $4K | $4K | 1.83% |
| CHUN-HA INSURANCE SERVICES, INC.3 Filed as: CHUN HA INSURANCE SERVICES INC | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 2.94% |
| GOOD FRIEND INSURANCE SERVICES LLC3 Filed as: GOOD FRIEND INSURANCE SERVICES, LLC | 3580 WILSHIRE BLVD # 1510 LOS ANGEELES, CA 90010 | EYEMED VISION CARE | $4K | — | $4K | 9.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.94% |
| CHUN-HA INSURANCE SERVICES, INC.3 Filed as: CHUN HA INSURANCE SERVICES INC | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $928 | — | $928 | 5.93% |
| CHUN-HA INSURANCE SERVICES, INC.3 Filed as: CHUN HA INSURANCE SERVICES INC | 9122 GARDEN GROVE BLVD GARDEN GROVE, CA 92844 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $637 | — | $637 | 4.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA | Contract Administrator; Non-monetary compensation; Named fiduciary; Participant communication; Claims processing; Other services; Float revenue; Direct payment from the plan Service code 12 | — | $0 |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 409 | $0 |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 643 | $241K |
| Vision | EYEMED VISION CARE | 656 | $36K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 271 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 270 | $26K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 271 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 656 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.