| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOOD GUTMANN & BOGART INSURANCE BRO3 | 15901 RED HILL AVENUE SUITE 100 TUSTIN, CA 92780 | KAISER FOUNDATION HEALTH PLAN INC | $27K | $9 | $27K | 4.95% |
| WOOD GUTMANN & BOGART INSURANCE BRO3 | 15901 RED HILL AVENUE SUITE 100 TUSTIN, CA 92780 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $2 | $6K | 5.02% |
| WOOD GUTMANN & BOGART INSURANCE BRO3 | 15901 RED HILL AVENUE SUITE 100 TUSTIN, CA 92780 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $9K | 7.97% |
| SANDRA SIMS3 Filed as: SANDRA ALLEN | 501 AGUA PLACE SEAL BEACH, CA 90740 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $473 | — | $473 | 24.19% |
| JULIE HILTSLEY3 | 3702 LONGVIEW DRIVE CARLSBAD, CA 92010 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $29 | — | $29 | 1.48% |
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 | 99 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 134 | $670K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $119K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $119K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $119K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $119K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.