| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $170K | $0 | $170K | 4.26% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | DELTA DENTAL OF CALIFORNIA | $39K | $0 | $39K | 5.00% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | SUN LIFE ASSURANCE COMPANY OF CANADA | $90K | $0 | $90K | 16.17% |
| ACE BENEFIT PARTNERS, INC.3 | 1013 EAST WINDING CREEK DRIVE EAGLE, ID 83616 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $28K | $28K | 5.03% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.81% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | DELTA DENTAL OF CALIFORNIA | $814 | $0 | $814 | 5.00% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY COMPANY INS. BROKERS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | HARTFORD LIFE AND ACCIDENT | $451 | $0 | $451 | 14.99% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | PO BOX 896620 CHARLOTTE, NC 28289 | HARTFORD LIFE AND ACCIDENT | $0 | $38 | $38 | 1.26% |
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 | 542 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 562 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 353 | $4.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 451 | $802K |
| Vision | VISION SERVICE PLAN | 481 | $84K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 526 | $557K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 526 | $557K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 526 | $557K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 353 | $4.0M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 542 | $560K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 542 | — |
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.