| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND, CA 913672584 | KAISER FOUNDATION HEALTH PLAN INC. | $75K | — | $75K | 2.72% |
| CHARLES W. TAPERT INSURANCE AGENCY3 Filed as: CHARLES W. TAPERT INSURANCE AGY INC | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 910241956 | KAISER FOUNDATION HEALTH PLAN INC. | $63K | $2K | $66K | 2.37% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, FL 12 WOODLAND HILLS, CA 913672561 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| DONALD W TAPERT INS AGCY INC3 Filed as: DONALD W. TAPERT INSURANCE AGY, INC | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 910241956 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.26% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | UNITED CONCORDIA INSURANCE COMPANY | $6K | — | $6K | 10.01% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $6K | — | $6K | 10.08% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, FL 12 WOODLAND HILLS, CA 913672561 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| DONALD W TAPERT INS AGCY INC3 Filed as: DONALD W. TAPERT INSURANCE AGY, INC | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 910241956 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.24% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, FL 12 WOODLAND, CA 913672561 | VISION SERVICE PLAN | $1K | $3 | $1K | 3.34% |
| TAPERT INSURANCE AGENCY3 Filed as: TAPERT INSURANCE AGENCY, INC. | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 910241956 | VISION SERVICE PLAN | $320 | — | $320 | 0.83% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, FL 12 WOODLAND HILLS, CA 913672584 | UNITED OF OMAHA LIFE INSURANCE | $1K | — | $1K | 15.01% |
| DONALD W TAPERT INS AGCY INC3 Filed as: DONALD W. TAPERT INSURANCE AGY, INC | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 910241956 | UNITED OF OMAHA LIFE INSURANCE | — | $196 | $196 | 2.28% |
| ARMAC INSURANCE AGENCY INC3 Filed as: ARMAC INSURANCE AGENCY | 17177 YUMA STREET VICTORVILLE, CA 92392 | AMERICAN FIDELITY ASSURANCE COMPANY | $55 | — | $55 | 9.93% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 W. 187TH PLACE TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $2 | $14 | 17.72% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 29811 SANTA MARGARITA PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $3 | $12 | 15.19% |
| RICHARD WAYNE BRYSON3 | 3777 LONG BEACH BLVD., SUITE 500 LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 11.39% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 5.06% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 1.27% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLASS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 1.27% |
| RICHARD WAYNE BRYSON3 | 3777 LONG BEACH BLVD., SUITE 500 LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $815 | — | $815 | — |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $578 | $161 | $739 | — |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLASS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $300 | $12 | $312 | — |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $198 | $74 | $272 | — |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALEZ | 11677 SANDPIPER COURT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $208 | — | $208 | — |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 W. 187TH PLACE TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | $11 | $139 | — |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMONT DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | $5 | $94 | — |
| ERIC BROGAN3 Filed as: ERIC SWANSON | 32101 FALL RIVER ROAD TRABUCO CANYON, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | — | $82 | — |
| RYAN THURSTON WHITTAKER3 | 33011 COMMODORE COURT SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | — | $71 | — |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $15 | $53 | — |
| ASCENSION BENEFITS ADVISORS3 | 6 POMEGRANATE STREET LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | — |
| UZIEL RIVERA3 | 543 CHEROKEE CIRCLE BANNING, CA 92220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | — |
| SADIE BLACKMON3 | 627 RAPIDS ROAD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | — |
| MIKE MCCORMICK3 | 348 S. STRONGS COURT SALT LAKE CITY, UT 84102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | — |
| GABRIEL HOLGUIN3 | 26342 FOREST BRIDGE DRIVE LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | — |
| EDWARD J THURIN3 Filed as: EDWARD J. THURIN | 17800 BRAZIER ROAD RIVERSIDE, CA 92508 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | — |
| JIM BARRETT3 | 8514 EAST KRAIL STREET SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | — |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GEORGE HORNE | 3410 MAGNOLIA WAY BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | P. O. BOX 365 POWAY, CA 92064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | — |
| BILL MUELLER3 | 7443 EADS AVENUE LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | — |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | — |
| CALVIN DEAN INGLE3 | 1840 LARIAT TRAIL CELINA, TX 75009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | — |
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 | 655 | 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) | 655 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 655 | $2.8M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 314 | $117K |
| Vision | VISION SERVICE PLAN | 257 | $38K |
| Life insurance(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 356 | $85K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $56K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 356 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 655 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.