| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INSURANCE SERVICES, | INC 1265 CARLSBAD VILLAGE DR.,SUITE 201 CARLSBAD, CA 92008 | CALIFORNIA PHYSICIANS' SERVICE | $18K | — | $18K | 5.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS' SERVICE | — | $8K | $8K | 2.13% |
| ANCHOR PACIFIC INSURANCE SERVICES3 | INC 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 920081972 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 5.00% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 2.51% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INSURANCE | SERVICES 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| EA LEGACY LLC5 Filed as: EA LEGACY LLC, | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.10% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INS SERVICES | 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $373 | $373 | 0.84% |
| ANCHOR PACIFIC INSURANCE SERVICES3 | DBA STEPHA 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 920081972 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 12.51% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | ATTN ACCOUNTING DEPT. 32110 AGOURA RD WESTLAKE VLG, CA 913614026 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.20% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | ATTN ACCOUNTING DEPT. 32110 AGOURA RD WESTLAKE VLG, CA 913614026 | PRINCIPAL LIFE INSURANCE COMPANY | — | $369 | $369 | 0.88% |
| STEPHANIE SAN ANTONIO INSURANCE3 | SERVICES 1265 CARLSBAD VILLAGE DRIVE STE 201 CARLSBAD, CA 92008 | MEDIEXCEL HEALTH PLAN | $2K | — | $2K | 7.07% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INSURANCE | SERVICES 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| EA LEGACY LLC5 Filed as: EA LEGACY LLC, | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $535 | $535 | 3.10% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INS SERVICES | 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $147 | $147 | 0.85% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INSURANCE | SERVICES 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| EA LEGACY LLC5 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $420 | $420 | 3.10% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INS SERVICES | 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $128 | $128 | 0.94% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INSURANCE | SERVICES 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| EA LEGACY LLC5 Filed as: EA LEGACY LLC, | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $356 | $356 | 3.10% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INS SERVICES | 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $124 | $124 | 1.08% |
| ANCHOR PACIFIC INSURANCE SERVICES3 Filed as: ANCHOR PACIFIC INSURANCE | SERVICES 1265 CARLSBAD VILLAGE DR STE 201 CARLSBAD, CA 92008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $851 | — | $851 | 10.00% |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 45 | $724K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 82 | $42K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 82 | $42K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $44K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 21 | $9K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 45 | $357K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 82 | — |
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.