| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICES | 2945 TOWNSGATE ROAD #200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $124K | — | $124K | 4.22% |
| TINA KARR3 | 15821 PORTOFINO SPRING BOULEVARD #107 FORT MEYERS, FL 33908 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | — | $8K | 0.28% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICES | 2945 TOWNSGATE ROAD #200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTHCARE OF CALIFORNIA, INC | $45K | — | $45K | 4.22% |
| TINA KARR3 | 15821 PORTOFINO SPRING BOULEVARD #107 FORT MYERS, FL 33908 | CIGNA HEALTHCARE OF CALIFORNIA, INC | $3K | — | $3K | 0.28% |
| AFFINITY GROUP BENEFITS LLC3 | 211 VILLAGE COMMONS BOULEVARD BUILDING UNIT 11 CAMARILLO, CA 93012 | KAISER FOUNDATION HEALTH PLAN, INC. | $40K | — | $40K | 4.61% |
| TINA KARR3 | 15821 PORTOFINO SPRINGS BOULEVARD APARTMENT 107 FORT MYERS, FL 33908 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | — | $2K | 0.24% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICES | 211 VILLAGE COMMONS BOULEVARD UNIT CAMARILLO, CA 93012 | PRINCIPAL LIFE INSURANCE COMPANY | $26K | — | $26K | 9.72% |
| TINA KARR3 Filed as: TINA LESLEE KARR | 15821 PORTOFINO SPRINGS BOULEVARD A FORT MYERS, FL 33908 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 0.64% |
| AFFINITY GROUP BENEFITS LLC3 | 211 VILLAGE COMMONS BOULEVARD BUILDING UNIT 11 CAMARILLO, CA 93012 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 4.62% |
| TINA KARR3 | 15821 PORTOFINO SPRINGS BOULEVARD APARTMENT 107 FORT MYERS, FL 33908 | KAISER FOUNDATION HEALTH PLAN, INC. | $509 | — | $509 | 0.32% |
| AFFINITY GROUP BENEFITS LLC3 | 2945 TOWNSGATE ROAD SUITE 200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 18.26% |
| AFFINITY GROUP BENEFITS LLC3 | 2945 TOWNSGATE ROAD SUITE 200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 18.34% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICES | 2945 TOWNSGATE ROAD #200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTHCARE OF COLORADO, INC. | $92 | — | $92 | 3.95% |
| TINA KARR3 | 15821 PORTOFINO SPRING BOULEVARD #107 FORT MYERS, FL 33908 | CIGNA HEALTHCARE OF COLORADO, INC. | $13 | — | $13 | 0.56% |
| TINA KARR3 | 15821 PORTOFINO SPRING BOULEVARD #107 FORT MYERS, FL 33908 | CIGNA HEALTHCARE OF FLORIDA, INC. | -$31 | — | -$31 | — |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICE | 2945 TOWNSGATE ROAD #200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTHCARE OF FLORIDA, INC. | -$178 | — | -$178 | — |
| TINA KARR3 | 15821 PORTOFINO SPRING BOULEVARD #107 FORT MEYERS, FL 33908 | CIGNA HEALTHCARE OF TENNESSEE, INC. | -$85 | — | -$85 | — |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICES | 2945 TOWNSGATE ROAD #200 WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTHCARE OF TENNESSEE, INC. | -$482 | — | -$482 | — |
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 | 425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 30 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 8 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 206 | $5.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $267K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $267K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $267K |
| Other(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 424 | $307K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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."
No prospect flags tripped on this filing.