| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOUSKA INSURANCE SERVICES INC.3 Filed as: HOUSKA INSURANCE SERVICES, INC. | 1230 ROSECRANS AVE SUITE #260 MANHATTAN BEACH, CA 90266 | WESTERN HEALTH ADVANTAGE | $13K | — | $13K | 2.60% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES | 900 NORTH SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | WESTERN HEALTH ADVANTAGE | $12K | — | $12K | 2.40% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC. | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 1.83% |
| HOUSKA INSURANCE SERVICES INC.3 Filed as: HOUSKA INSURANCE SERVICES, INC. | 1230 ROSECRANS AVE STE 260 MANHATTAN BEACH, CA 902662477 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.25% |
| HOUSKA INSURANCE SERVICES INC.3 Filed as: HOUSKA INS SVCS | 1230 ROSECRANS AVE STE #260 MANHATTAN BEACH, CA 90266 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.72% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.28% |
| HOUSKA INSURANCE SERVICES INC.3 Filed as: HOUSKA INS SVCS | 1230 ROSECRANS AVE STE #260 MANHATTAN BEACH, CA 90266 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $896 | — | $896 | 7.00% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $538 | — | $538 | 4.21% |
| HOUSKA INSURANCE SERVICES INC.3 Filed as: HOUSKA INS SERVICES INC | 1230 ROSECRANS AVE STE 260 MANHATTAN BCH, CA 902662477 | HUMANA INSURANCE COMPANY | $640 | — | $640 | 5.98% |
| VITA INSURANCE ASSOCIATES, INC.3 Filed as: VITA INSURANCE ASSOCIATES INC | 900 N SHORELINE BLVD MOUNTAIN VIEW, CA 94043 | HUMANA INSURANCE COMPANY | $413 | — | $413 | 3.86% |
| HOUSKA INSURANCE SERVICES INC.3 Filed as: HOUSKA INSURANCE SERVICES, INC | 1230 ROSECRANS AVE., SUITE 260 MANHATTAN BEACH, CA 90266 | PREMIER ACCESS INSURANCE COMPANY | $1K | — | $1K | 14.08% |
| VITA INSURANCE ASSOCIATES, INC.3 | 900 NORTH SHORELINE BOULEVARD MOUNTAIN VIEW, CA 94043 | PREMIER ACCESS INSURANCE COMPANY | $668 | — | $668 | 6.91% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 105 | $712K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 80 | $10K |
| Vision | HUMANA INSURANCE COMPANY | 83 | $11K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 97 | $13K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 95 | $26K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 105 | $712K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 97 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.