| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMS AND ASSOCIATES INS. BROKERS3 | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 3.91% |
| POMS AND ASSOCIATES INS. BROKERS3 | 5700 CANOGA AVENUE, SUITE 400 WOODLAND HILLS, CA 91367 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.66% |
| POMS & ASSOCIATES INSURANCE BROKERS3 Filed as: POMS AND ASSOCIATES INSURANCE | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | CALIFORNIA DENTAL NETWORK, INC. | $1K | — | $1K | 10.00% |
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 | 99 | 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. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 102 | $437K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 64 | $42K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 102 | $437K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 102 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.