| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMS & ASSOCIATES INSURANCE BROKERS3 | LLC 4500 PARK GRANADA, SUITE 206 CALABASAS, CA 91302 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $90K | — | $90K | 4.53% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | INC 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $25K | $25K | 1.27% |
| POMS & ASSOCIATES INSURANCE BROKERS3 Filed as: POMS & ASSOCIATES INSURANCE | BROKERS, INC. 4500 PARK GRANADA, SUITE 206 CALABASAS, CA 913021681 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | — | $18K | 4.64% |
| POMS AND ASSOCIATES INS. BROKERS3 Filed as: POMS & ASSOC INS BROKERS LLC | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 5.34% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | — | $231 | $231 | 0.53% |
| POMS AND ASSOCIATES INS. BROKERS3 Filed as: POMS & ASSOC INS BROKERS LLC | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | ANTHEM LIFE INSURANCE COMPANY | $4K | — | $4K | 10.15% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | — | $1K | $1K | 2.61% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | $325 | — | $325 | 0.77% |
| POMS AND ASSOCIATES INS. BROKERS3 Filed as: POMS & ASSOC INS BROKERS LLC | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 6.76% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | — | $110 | $110 | 0.52% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 95361 | ANTHEM LIFE INSURANCE COMPANY | $32 | — | $32 | 0.15% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | LLC 5700 CANOGA AVE SUITE 400 WOODLAND HILLS, CA 91367 | STANDARD INSURANCE COMPANY | $915 | — | $915 | 10.45% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | INC 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | STANDARD INSURANCE COMPANY | — | $197 | $197 | 2.25% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 325 | $2.4M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 325 | $2.0M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 325 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 190 | $52K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 190 | $51K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 190 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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.