| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIXON BENEFITS3 | 620 NEWPORT CENTER DR FL 11 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC | $124K | — | $124K | 3.10% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE CO LLC | 1820 E FIRST ST SUITE 400 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 4.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 1.67% |
| JUND BRIAN EDWARD3 | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $558 | — | $558 | 0.44% |
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 | 1,558 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,572 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 670 | $4.0M |
| Vision | VISION SERVICE PLAN | 2,092 | $205K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 343 | $481K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 295 | $330K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 670 | $4.0M |
| Other(5 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,558 | $568K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,092 | — |
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.