| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIXON BENEFITS3 | 620 NEWPORT CENTER DR., 11TH FLOOR NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $99K | — | $99K | 2.52% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE CO INC. | 1820 E. FIRST ST., SUITE 400 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $30K | — | $30K | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N. BRAND BLVD., 6TH FLOOR GLENDALE, CA 91203 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13K | — | $13K | 4.35% |
| NATIONAL BENEFIT PARTNERS3 | 23282 MILL CREEK DR., SUITE 390 LAGUNA HILLS, CA 92653 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 0.74% |
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 | 2,015 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,027 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 859 | $3.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 228 | $196K |
| Vision | VISION SERVICE PLAN | 1,603 | $219K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,620 | $681K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 828 | $307K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 859 | $3.9M |
| Other(5 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,015 | $723K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,015 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.