| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUDY INSURANCE AGENCIES, INC.3 | 11661 SAN VICENTE BLVD SUITE 704 LOS ANGELES, CA 90049 | KAISER FOUNDATION HEALTH PLAN, INC. (MEDICAL) | $38K | — | $38K | 4.00% |
| FOUDY INSURANCE AGENCIES, INC.3 | 11661 SAN VICENTE BLVD SUITE 704 LOS ANGELES, CA 90049 | UNUM LIFE INSURANCE COMPANY OF AMERICA (ADD/LIFE/LTD) | $7K | — | $7K | 10.92% |
| FOUDY INSURANCE AGENCIES, INC.3 | 11661 SAN VICENTE BLVD SUITE 704 LOS ANGELES, CA 90049 | DELTA DENTAL (DENTAL-00170) | $2K | — | $2K | 4.00% |
| FOUDY INSURANCE AGENCIES, INC.3 | 11661 SAN VICENTE BLVD SUITE 704 LOS ANGELES, CA 90049 | GROUP HEALTH COOPERATIVE (MEDICAL) | $901 | — | $901 | 2.46% |
| FOUDY INSURANCE AGENCIES, INC.3 | 11661 SAN VICENTE BLVD SUITE 704 LOS ANGELES, CA 90049 | VISION SERVICE PLAN (VISION) | $1K | — | $1K | 5.86% |
| FOUDY INSURANCE AGENCIES, INC.3 | 11661 SAN VICENTE BLVD SUITE 704 LOS ANGELES, CA 90049 | DELTA DENTAL (DENTAL-71779) | $1K | — | $1K | 10.00% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. (MEDICAL) | 159 | $990K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL (DENTAL-00170) | 100 | $57K |
| Vision | VISION SERVICE PLAN (VISION) | 60 | $17K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA (ADD/LIFE/LTD) | 120 | $60K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA (ADD/LIFE/LTD) | 120 | $60K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA (ADD/LIFE/LTD) | 120 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.