| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $30K | $0 | $30K | 3.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $4 | $8K | 1.03% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $19K | $0 | $19K | 4.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $0 | $9K | 1.89% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | UNKNOWN WOODLAND HILLS, CA 91367 | UNITED CONCORDIA INSURANCE COMPANY | $7K | $0 | $7K | 8.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | UNITED CONCORDIA INSURANCE COMPANY | $3K | $811 | $4K | 4.12% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | SYMETRA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 11.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | SYMETRA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.66% |
| DENNY P. TWIGG3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $3K | $79 | $3K | 8.17% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | AFLAC | $1K | $0 | $1K | 3.05% |
| KEVIN MICHAEL NAGLE3 | 32 ESPERANZA AVENUE APARTMENT F SIERRA MADRE, CA 91024 | AFLAC | $1K | $18 | $1K | 2.49% |
| GRIS BARRON IBARRA3 | 18824 CEDAR VALLY WAY NEWHALL, CA 91321 | AFLAC | $873 | $0 | $873 | 2.12% |
| ANDRES ORLANDO TRUJILLO3 | 205 SOUTH BROADWAY, SUITE 208 LOS ANGELES, CA 90012 | AFLAC | $401 | $5 | $406 | 0.99% |
| MICHAEL R. FISHER3 | 50 WEST LEMON AVENUE, SUITE 2 MONROVIA, CA 91016 | AFLAC | $363 | $13 | $376 | 0.91% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | 6200 CANOGA AVENUE, SUITE 325 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $814 | $0 | $814 | 6.19% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $439 | $0 | $439 | 3.34% |
| 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. | $254 | $0 | $254 | 1.93% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS OF THE WEST, LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $519 | $0 | $519 | 8.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $198 | $59 | $257 | 4.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $164 | $0 | $164 | 2.82% |
| JERRY HASSON3 | 850 EAST OCEAN BOULEVARD UNIT 908 LONG BEACH, CA 90802 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $736 | $0 | $736 | 17.22% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SVCS. OF THE WEST LLC | 6200 CANOGA AVENUE, SUITE 325 WOODLAND HILLS, CA 91367 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $279 | $0 | $279 | 6.53% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 92 | $1.3M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 148 | $91K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 182 | $13K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 114 | $99K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 114 | $58K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 114 | $58K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 92 | $1.3M |
| Other(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 114 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.