| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC | $38K | $0 | $38K | 3.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE STREET VISALIA, CA 93292 | KAISER FOUNDATION HEALTH PLAN INC | $7K | $0 | $7K | 0.66% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | -$355 | $0 | -$355 | -0.03% |
| GALLAGHR BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 10.55% |
| CYNTHIA LUQUIN3 | 2001 EAST FINANCIAL WAY, SUITE 102 GLENDORA, CA 91741 | AFLAC | $3K | $59 | $3K | 6.11% |
| KIMBERLY O. KWOK3 | 2044 COBBLEFIELD WAY GLENDORA, CA 91740 | AFLAC | $1K | $86 | $1K | 3.46% |
| MJ INSURANCE3 Filed as: DAVID M. SMITH AND VARIOUS AGENTS | 2001 EAST FINANCIAL WAY, SUITE 102 GLENDORA, CA 91741 | AFLAC | $749 | $57 | $806 | 1.92% |
| DAVID J REESOR3 Filed as: DAVID . RESSOR | 1615 WILSON AVENUE UPLAND, CA 91784 | AFLAC | $713 | $0 | $713 | 1.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $519 | $0 | $519 | 1.24% |
| PARKVILLE INS SVCS INC3 Filed as: PARKVILLE INSURANCE SERVICES INC. | PO BOX 1275 WHITTIER, CA 90609 | AFLAC | $371 | $0 | $371 | 0.89% |
| HEFFERNAN INSURANCE BROKERS3 | PO BOX 4006 WALNUT CREEK, CA 94596 | AFLAC | $257 | $0 | $257 | 0.61% |
| JERRY B. RAY3 | 201 KNOXVILLE AVENUE HUNTINGTON BEACH, CA 92648 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $233 | $0 | $233 | 4.59% |
| THE AGURS GROUP INC.3 | 5721 FRENCH LACE COURT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $62 | $0 | $62 | 1.22% |
| KIM GOODSITE3 | 3400 AVENUE OF THE ARTS APARTMENT B313 COSTA MESA, CA 92626 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $22 | $0 | $22 | 0.43% |
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 | 158 | 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) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 157 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $108K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $108K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $108K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $150K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $150K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 157 | $1.1M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 158 | $155K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.