| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE, INC. | PO BOX 28906 FRESNO, CA 93729 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | $0 | $14K | 4.45% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE, BUILDING 3 SUITE 200 SACRAMENTO, CA 95826 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 0.74% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92502 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $6K | $17K | 9.86% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE, BUILDING 3 SUITE 200 SACRAMENTO, CA 95826 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.84% |
| CHIMIENTI & ASSOCIATES3 | 3130 WEST MAIN STEET, SUITE D VISALIA, CA 93291 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 21.03% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES, INC. | 8950 CAL CENTER DRIVE, SUITE 200 SACRAMENTO, CA 95826 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.97% |
| NATIONAL BENEFIT PARTNER WEST LLC3 Filed as: NATIONAL BENEFIT PARTNER WEST, LLC | 99 WOOD AVENUE SOUTH, SUITE 501 ISELIN, NJ 08830 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.00% |
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 | 188 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 40 | $316K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $170K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $170K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $223K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 57 | $53K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $170K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 40 | $316K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.