| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $44K | $0 | $44K | 4.75% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $58K | $0 | $58K | 9.46% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 3.18% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE | $2K | $0 | $2K | 9.21% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $0 | $10K | 55.29% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE STE 325 WOODLAND HILLS, CA 91367 | UNUM INSURANCE COMPANY | $3K | $162 | $3K | 15.90% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $1K | $3K | 17.61% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $610 | $610 | 4.20% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $318 | $318 | 2.83% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNON AGENCY | 9171 TOWNE CENTRE STE 500 SAN DIEGO, CA 92122 | UNUM INSURANCE COMPANY | $574 | $88 | $662 | 7.01% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA MANIACI INS | 500 SILVER SPUR RD STE 121 ROLLING HILLS ESTATE, CA 90275 | UNUM INSURANCE COMPANY | $445 | $0 | $445 | 4.71% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE SUITE 325 WOODLAND HILLS, CA 91367 | UNUM INSURANCE COMPANY | $350 | $56 | $406 | 4.30% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE STE 500 SAN DIEGO, CA 92122 | UNUM INSURANCE COMPANY | $626 | $97 | $723 | 9.79% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA MANIACI INS | 500 SILVER SPUR RD STE 121 ROLLING HILLS ESTATE, CA 90275 | UNUM INSURANCE COMPANY | $317 | $0 | $317 | 4.29% |
| PCF INSURANCE SERVICES OF THE WEST3 | 6200 CANOGA AVE STE 325 WOODLAND HILLS, CA 91367 | UNUM INSURANCE COMPANY | $162 | $26 | $188 | 2.55% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD SUITE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $805 | $0 | $805 | 15.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $223 | $223 | 4.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA LIFE AND HEALTH INSURANCE CO EIN 59-1031071 PLAN ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Plan Administrator Service code 12 | 400 N BRAND BLVD 3RD FLOOR GLENDALE, CA 91203 | $211K |
| CIGNA | Contract Administrator; Non-monetary compensation; Other services; Direct payment from the plan; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $0 |
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 | 165 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 165 | $1.5M |
| Dental(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 113 | $37K |
| Vision | EYEMED VISION CARE | 297 | $21K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $66K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $15K |
| Other(6 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 297 | — |
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.