| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | KAISER FOUNDATION HEALTH PLANS INC | $4K | — | $4K | 0.24% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | BLUE SHIELD OF CALIFORNIA | $2K | — | $2K | 1.30% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 7.99% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 10.00% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE SUITE 200 WALNUT CREEK, CA 94596 | HARTFORD LIFE AND ACCIDENT | $382 | — | $382 | 0.65% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | HEALTH NET OF CALIFORNIA, INC. | $266 | — | $266 | 0.67% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | TRANSAMERICA LIFE INSURANCE COMPANY | $8K | — | $8K | 52.50% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | EYEMED VISION CARE | $1K | — | $1K | 9.23% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $26 | — | $26 | 0.54% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | OSCAR INSURANCE CORPORATION | $175 | — | $175 | 4.28% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | WESTERN HEALTH ADVANTAGE | $115 | — | $115 | 3.03% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA ROAD SUITE 100 AGOURA HILLS, CA 91301 | CALIFORNIA DENTAL NETWORK, INC. | $347 | — | $347 | 10.01% |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 7 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 151 | $1.8M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 230 | $126K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 231 | $1.6M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 153 | $59K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 153 | $59K |
| Prescription drug(6 contracts, 6 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 151 | $1.6M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 240 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.