| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | GUARDIAN | $123K | $3K | $126K | 11.74% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN REGION CA | — | $35K | $35K | 3.58% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN REGION CA | $16K | — | $16K | 2.58% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $91K | — | $91K | 15.85% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $71K | — | $71K | 13.30% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE, SUITE 325 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $55K | — | $55K | 12.32% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | GUARDIAN | $72K | $1K | $74K | 24.11% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | FIDELITY SECURITY LIFE INSURANEC COMPANY | $23K | $0 | $23K | 11.58% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS - SEE ATTACHED STATEMENT | — | AFLAC | $26K | $1K | $27K | 14.91% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | $0 | $12K | 9.49% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER C FOY & ASSOC INS SVS INC | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $132 | $0 | $132 | 0.11% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS SERVICES OF THE WEST LLC | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN REGION CO | $1K | $0 | $1K | 1.16% |
| CLARK & ASSOCIATES3 | 520 HAMMILL LANE RENO, NV 89511 | PROMINENCE HEALTH PLAN | $4K | $0 | $4K | 7.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF CALIFORNIA INC | $5K | $0 | $5K | 10.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF TEXAS, INC. | $2K | — | $2K | 10.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $867K | — | $867K | 4462.84% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. | $898 | — | $898 | 10.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF ILLINOIS, INC | $704 | $0 | $704 | 10.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF FLORIDA INC | $574 | $0 | $574 | 9.99% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC | $556 | — | $556 | 10.01% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF NORTH CAROLINA | $505 | — | $505 | 10.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF COLORADO INC | $333 | $0 | $333 | 9.99% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF OHIO, INC | $310 | — | $310 | 9.99% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF KENTUCKY | $255 | $0 | $255 | 10.01% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF VIRGINIA, INC | $245 | — | $245 | 9.98% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF KANSAS, INC | $222 | $0 | $222 | 9.99% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF DELEWARE INC | $167 | — | $167 | 10.02% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF NEW JERSEY, INC | $167 | — | $167 | 10.02% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTHCARE OF CONNECTICUT, INC. | $144 | — | $144 | 10.03% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF MARYLAND, INC | $107 | — | $107 | 10.05% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA DENTAL HEALTH OF MISSOURI, INC | $56 | $0 | $56 | 10.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH I EIN 95-4331852 PLAN ADMINISTRATOR | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $1.9M |
| INGENIO RX EIN 82-3062245 PRESCRIPTION DRUG ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $661K |
| UNUM LIFE INSURANCE CO OF AMERICA EIN 01-0278678 N/A | Claims processing Service code 12 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $70K |
| ANTHEM BLUE CROSS LIFE & HEALTH INS | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
| CARELONRX, INC | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $0 |
| CARELON RX, INC EIN 82-3062245 PRESCRIPTION DRUG ADMIN | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | 3075 VANDERCAR WAY CINCINNATI, OH 45206 | -$134K |
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 | 2,548 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,548 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN REGION CA | 129 | $1.8M |
| Dental(19 contracts, 19 carriers) | GUARDIAN | 1,403 | $1.3M |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANEC COMPANY | 3,612 | $216K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,548 | $980K |
| Short-term disability | GUARDIAN | 748 | $305K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,548 | $535K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,548 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,612 | — |
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.