| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMS & ASSOCIATES INSURANCE BROKERS3 | PO BOX 80517 CITY OF INDUSTRY, CA 91716 | KAISER FOUNDATION HEALTH PLAN INC | $70K | — | $70K | 4.23% |
| POMS & ASSOCIATES INSURANCE BROKERS3 Filed as: POMS AND ASSOCIATES INSURANCE | 5700 CANOGA AVENUE WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $67K | — | $67K | 5.00% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 7935 EAST PRENTIVE AVENUE SUITE 110-W GREENWOOD VILLAGE, CO 80111 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $27K | $199 | $27K | 10.08% |
| RAOUL HAMILTON3 | 443 WEST 93RD STREET INGLEWOOD, CA 90301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22K | — | $22K | 9.12% |
| MIKE MCCORMICK3 | 348 SOUTH STRONGS COURT SALT LAKE CITY, UT 84102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 4.36% |
| DAVID A. RACKLIFFE3 | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $532 | $6K | 2.54% |
| MICHAEL JAMES LANCASTER3 | 22365 EL TORO ROAD LAKE FOREST, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.66% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL FAHEY III AND OTHER AGENTS | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $446 | $3K | 1.42% |
| SHERRI BARHAM3 | 24694 PASEO DE TORONTO YORBA LINDA, CA 92887 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $42 | $3K | 1.40% |
| ELAINE G EVERETT3 Filed as: ELAINE G. EVERETT | PO BOX 1312 LA MIRADA, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.59% |
| BENEFIT COMMUNICATIONS INS. SVC.3 | 29811 SANTA MARGARITA PARKWAY SUITE 100 RANCHO SANTA MARGARITA, CA 92688 | RELIASTAR LIFE INSURANCE COMPANY | $6K | — | $6K | 7.27% |
| RAOUL HAMILTON3 | 10608 CRENSHAW BOULEVARD APARTMENT 3 INGLEWOOD, CA 90303 | RELIASTAR LIFE INSURANCE COMPANY | $6K | — | $6K | 7.27% |
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 | 432 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 301 | $3.0M |
| Dental(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 434 | $1.6M |
| Vision(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 434 | $1.6M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 452 | $82K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 452 | $82K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 301 | $3.0M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 452 | $322K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 452 | — |
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.