| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $50K | $0 | $50K | 5.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $27K | $0 | $27K | 5.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | SYMETRA LIFE INSURANCE COMPANY | $12K | $3K | $15K | 18.96% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SERVICES | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | SYMETRA LIFE INSURANCE COMPANY | -$39 | — | -$39 | -0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5455 RINGS ROAD, SUITE 250 DUBLIN, OH 43017 | UNITED CONCORDIA INSURANCE COMPANY | $4K | $2K | $7K | 8.68% |
| DENNY P. TWIGG3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $2K | $38 | $2K | 4.51% |
| KEVIN MICHAEL NAGLE3 | 32 ESPERANZA AVENUE, APARTMENT F SIERRA MADRE, CA 91024 | AFLAC | $652 | $6 | $658 | 1.89% |
| GRIS BARRON IBARRA3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $575 | $0 | $575 | 1.65% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 520 HAMMILL LANE WOODLAND HILLS, CA 89511 | AFLAC | $518 | $0 | $518 | 1.49% |
| MICHAEL R. FISHER3 | 50 WEST LEMON AVENUE, SUITE 2 MONROVIA, CA 91016 | AFLAC | $278 | $0 | $278 | 0.80% |
| ANDRES ORLANDO TRUJILLO3 | 21338 MONETA AVENUE CARSON, CA 90745 | AFLAC | $140 | $6 | $146 | 0.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | AFLAC | $36 | $0 | $36 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $996 | $0 | $996 | 9.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5455 RINGS ROAD, SUITE 250 DUBLIN, OH 43017 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $724 | $217 | $941 | 14.04% |
| HASSON FINANCIAL FREEDOM LLC4 Filed as: HASSON FINANCIAL FREEDOM, LLC | 850 EAST OCEAN BOULEVARD, UNIT 908 LONG BEACH, CA 90802 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $820 | $0 | $820 | 14.27% |
| PCF INSURANCE SERVICES OF THE WEST4 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 6200 CANOGA AVENUE, SUITE 325 WOODLAND HILLS, CA 91367 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $195 | $0 | $195 | 3.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $190 | $0 | $190 | 3.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $129 | $0 | $129 | 2.41% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 95 | $1.4M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 152 | $82K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 192 | $11K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 115 | $114K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 115 | $79K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 115 | $79K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 95 | $1.4M |
| Other(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 115 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.