| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID GEORGE CARVER3 Filed as: DAVID CARVER | 400 OCEANGATE SUITE 700 LONG BEACH, CA 90802 | KAISER FOUNDATION HEALTH PLAN, INC. | $40K | — | $40K | 2.64% |
| SALLY COKER3 | 38275 NORTH 103RD PLACE SCOTTSDALE, AZ 85262 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | — | $17K | 1.13% |
| DAVID J MCCLELLAN3 Filed as: DAVID G CARVER | 100 OCEANGATE BOULEVARD SUITE 800 LONG BEACH, CA 90802 | BLUE SHIELD OF CALIFORNIA | — | $9K | $9K | 2.54% |
| SALLY COKER3 Filed as: SALLY INGRAM COKER | 6511 EAST RENDINA STREET LONG BEACH, CA 90815 | BLUE SHIELD OF CALIFORNIA | — | $4K | $4K | 1.09% |
| DAVID GEORGE CARVER3 Filed as: DAVID CARVER | 400 OCEANGATE #700 LONG BEACH, CA 90802 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | — | $8K | 6.98% |
| SALLY COKER3 | 38275 NORTH 103RD PLACE SCOTTSDALE, AZ 85262 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 2.99% |
| DAVID GEORGE CARVER3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| DAVID GEORGE CARVER3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| DAVID GEORGE CARVER3 | 400 OCEANGATE #700 LONG BEACH, CA 90802 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $184 | — | $184 | 10.02% |
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 | 330 | 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) | 330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 350 | $1.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 325 | $121K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 325 | $121K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 377 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 377 | $12K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 154 | $355K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 377 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.