| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNY CHANG3 | 2048 S HACIENDA BLVD HACIENDA HEIGHTS, CA 917454240 | UNITEDHEALTHCARE INSURANCE COMPANY | $57K | — | $57K | 3.81% |
| KCAL HEALTH INSURANCE SERVICES3 | 2048 S HACIENDA BLVD HACIENDA HTS, CA 917454240 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | — | $19K | 1.29% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 1.02% |
| KCAL HEALTH INSURANCE SERVICES3 | 2128 S HACIENDA BLVD HACIENDA HEIGHTS, CA 917454242 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | — | $16K | 4.92% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 1.35% |
| KCAL HEALTH INSURANCE SERVICES3 | 2048 S HACIENDA BLVD HACIENDA HEIGHTS, CA 917454240 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $2K | $16K | 5.97% |
| AMWINS3 Filed as: LISI LLC D/B/A AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | METROPOLITAN LIFE INSURANCE COMPANY | $205 | $17 | $222 | 0.08% |
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 | 215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 295 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 505 | $264K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 505 | $264K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 505 | $264K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 505 | $264K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 505 | $264K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 505 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.