| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | KAISER FOUNDATION HEALTH PLAN, INC. | $34K | — | $34K | 3.00% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | DELTA DENTAL OF CALIFORNIA | $0 | $8K | $8K | 5.84% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 11.94% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | — | $8K | 16.04% |
| CHARLES N. CRAVINGS JR3 Filed as: CHARLES NATHANIEL CRAVINGS JR | 1467 W 49TH ST LOS ANGELES, CA 90062 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 10.58% |
| CARLOS DAVID HERNANDEZ3 | 4738 W 136TH ST HAWTHORNE, CA 90250 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.34% |
| MARK LEWIS BIALOCK3 | 5308 CORTE PLAYA JACINTO SAN DIEGO, CA 92124 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 2.25% |
| CHRISTOPHER D. JUDY3 Filed as: CHRISTOPHER DALE JUDY | 12051 VERANO ST SAN DIEGO, CA 92128 | CONTINENTAL AMERICAN INSURANCE COMPANY | $265 | — | $265 | 0.56% |
| KEN MAJOR3 Filed as: KEN L MAJOR | 9622 OLYMPIC DRIVE HUNTINGTON BEACH, CA 92646 | CONTINENTAL AMERICAN INSURANCE COMPANY | $160 | — | $160 | 0.34% |
| BRANDON TYLOR-DA SHIRLEY3 Filed as: BRANDON TYLOR-DAVID SHIRLEY | 5110 S SHERBOURNE DR LOS ANGELES, CA 90056 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | VISION SERVICE PLAN | $3K | — | $3K | 9.98% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 10.96% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.99% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | STANDARD INSURANCE COMPANY | $654 | — | $654 | 10.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, LLC EIN 36-3086057 TPA TO THE EMPLOYER | Claims processing Service code 12 | — | $176K |
| SALLY COKER HEALTH BROKER CONSULTANT | Insurance agents and brokers Service code 22 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | $109K |
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 | 214 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 116 | $1.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 291 | $142K |
| Vision | VISION SERVICE PLAN | 221 | $31K |
| Life insurance | STANDARD INSURANCE COMPANY | 226 | $73K |
| Short-term disability | STANDARD INSURANCE COMPANY | 22 | $6K |
| Long-term disability | STANDARD INSURANCE COMPANY | 226 | $27K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE OF CANADA | 114 | $573K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 94 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.