| 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 | $32K | $0 | $32K | 4.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $28K | $455 | $28K | 5.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN DUBLIN, OH 43017 | UNITED CONCORDIA INSURANCE COMPANY | $3K | $2K | $6K | 7.36% |
| UNKNOWN3 | UNKNOWN LOS ANGELES, CA 90012 | SYMETRA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 13.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.48% |
| DENNY P. TWIGG3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $3K | $102 | $3K | 6.56% |
| KEVIN MICHAEL NAGLE3 | 32 ESPERANZA AVENUE, SUITE F SIERRA MADRE, CA 91024 | AFLAC | $953 | $24 | $977 | 2.29% |
| GRIS BARRON IBARRA3 | 18824 CEDAR VALLEY WAY NEWHALL, CA 91321 | AFLAC | $791 | $0 | $791 | 1.85% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 520 HAMMILL LANE WOODLAND HILLS, CA 89511 | AFLAC | $595 | $0 | $595 | 1.39% |
| MJ INSURANCE3 Filed as: MICHAEL R FISHER AND VARIOUS AGENTS | 50 WEST LEMON AVENUE, SUITE 2 GLENDALE, CA 91203 | AFLAC | $445 | $0 | $445 | 1.04% |
| ADRES ORLANDO TRUJILLO3 | 205 SOUTH BROADWAY, SUITE 208 LOS ANGELES, CA 90012 | AFLAC | $341 | $24 | $365 | 0.85% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS. SERVICES OF THE WEST, LLC | 21300 VICTORY BOULEVARD, SUITE 700 WOODLAND HILLS, CA 91367 | AFLAC | $344 | $0 | $344 | 0.81% |
| 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. | $1K | $0 | $1K | 10.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $157 | $0 | $157 | 2.76% |
| JERRY HASSON4 | 850 EAST OCEAN BOULEVARD, SUITE 908 LONG BEACH, CA 90802 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $646 | $0 | $646 | 12.55% |
| 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 | $305 | $0 | $305 | 5.92% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $32 | $0 | $32 | 0.62% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 97 | $1.3M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 164 | $75K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 187 | $9K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 121 | $101K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 121 | $58K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 121 | $58K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 97 | $1.3M |
| Other(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 121 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.