| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MATRIX INSURANCE AGENCY3 Filed as: MATRIX GROUP INSURANCE AGENCY | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | UNITEDHEALTHCARE INSURANCE COMPANY | $53K | $0 | $53K | 4.62% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES, | 32110 AGOURA RD WEST LAKE VILLAGE, CA 91361 | UNITEDHEALTHCARE INSURANCE COMPANY | $21K | $0 | $21K | 1.85% |
| MATRIX INSURANCE AGENCY3 | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | $0 | $22K | 10.80% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 32110 AGOURA RD WEST LAKE, CA 91361 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 5.00% |
| MATRIX INSURANCE AGENCY3 | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $0 | $10K | 4.92% |
| MATRIX INSURANCE AGENCY3 | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | $0 | $6K | 5.07% |
| MATRIX INSURANCE AGENCY3 | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MATRIX GROUP INS AGENCY ADMINISTRATOR | Contract Administrator Service code 13 | 42840 CHRISTY ST SUITE 107 FREMONT, CA 94538 | $93K |
| WARNER PACIFIC INS SERVICES ADMINISTRATPR | Contract Administrator Service code 13 | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | $31K |
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 | 190 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 163 | $1.5M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $200K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 124 | $25K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $200K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $200K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 47 | $320K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 190 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.