| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | BLUE CROSS OF CALIFORNIA | $115K | — | $115K | 4.96% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | — | $48K | $48K | 2.07% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $47K | — | $47K | 5.42% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2677 N MAIN STREET. SUITE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 1.05% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $29K | — | $29K | 5.11% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2677 N MAIN STREET. SUITE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 0.88% |
| CMR RISK & INSURANCE SERVICES, INC.3 Filed as: CMR RISK & INSURANCE SERVICES | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $2K | $14K | 17.98% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $12K | 18.56% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 14.45% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 4.96% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $826 | $826 | 2.06% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 13.40% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $898 | $4K | 13.35% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $44 | $4K | 15.17% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 | 110 W A STREET, SUITE 725 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $885 | $3K | 13.70% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2 ENTERPRISE DR STE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
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 | 482 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 483 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 604 | $3.7M |
| Dental | BLUE CROSS OF CALIFORNIA | 604 | $2.3M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 610 | $40K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 482 | $102K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 482 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 482 | $66K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 89 | $1.4M |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 482 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 610 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.