| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION INSURANCE SERVICES INC | 80 S LAKE AVENUE STE 600 PASADENA, CA 91101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $21K | $0 | $21K | 5.02% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 4851 LBJ FREEWAY #1100 DALLAS, TX 75244 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $5K | $5K | 1.13% |
| SEAN T. BORCHARDT3 | 7673 N INGRAM AVE STE 103 FRESNO, CA 93711 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | -$46 | $0 | -$46 | -0.01% |
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION INSURANCE SERVICES, INC. | 80 S LAKE AVE STE 600 PASADENA, CA 91101 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | $0 | $9K | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC. | $0 | $356 | $356 | 0.15% |
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION INSURANCE SERVICES, INC. | 80 S LAKE AVE STE 600 PASADENA, CA 91101 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $0 | $5K | 4.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE THE GALLACHER CENTRE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC. | -$42 | $277 | $235 | 0.21% |
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION INSURANCE SERVICES | 1610 ARDEN WAY STE 121 SACRAMENTO, CA 95815 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 5.38% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $753 | $0 | $753 | 0.70% |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 187 | $756K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 186 | $108K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 187 | $416K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 186 | $108K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 186 | $108K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 186 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.