| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 80 S LAKE AVENUE SUITE 600 PASADENA, CA 91101 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $20K | $0 | $20K | 3.33% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN SERVICES | 6200 CANOGA AVENUE SUITE 300 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $5K | $5K | 0.88% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | PO BOX 5356 FRESNO, CA 93755 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 0.35% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN SERVICES | 21650 OXNARD STREET SUITE 200 WOODLAND HILL, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $570 | $570 | 0.09% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 80 S LAKE AVENUE SUITE 600 PASADENA, CA 91101 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | $0 | $20K | 4.00% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES, INC. | 7673 N INGRAMM AVENUE SUITE 103 FRESNO, CA 93711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 3.96% |
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 | 218 | 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) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 278 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $145K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 278 | $611K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $145K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $145K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.