| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE STE 1200 WOODLAND HILLS, CA 913672584 | KAISER FOUNDATION HEALTH PLAN, INC. | $76K | — | $76K | 2.43% |
| BXA INSURANCE SERVICES3 | 23716 BIRTCHER DR LAKE FOREST, CA 926301771 | KAISER FOUNDATION HEALTH PLAN, INC. | $66K | — | $66K | 2.11% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | UNITED CONCORDIA INSURANCE COMPANY | $5K | — | $5K | 5.45% |
| BENEFIT EXCHANGE ALLIANCE3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | UNITED CONCORDIA INSURANCE COMPANY | $4K | — | $4K | 4.83% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCES, INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 926301771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 8.03% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE. FLOOR 12 WOODLAND HILLS, CA 913672584 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 6.97% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $5K | — | $5K | 7.45% |
| BENEFIT EXCHANGE ALLIANCE3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $4K | — | $4K | 6.60% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE FLOOR 12 WOODLAND HILLS, CA 913672584 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.59% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE, INC. | 23716 BIRTCHER DR LAKE FOREST, CA 926301771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.41% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE FLOOR 12 WOODLAND HILLS, CA 913672584 | VISION SERVICE PLAN | $1K | — | $1K | 2.84% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | VISION SERVICE PLAN | $502 | — | $502 | 1.28% |
| RICHARD WAYNE BRYSON3 | 3777 LONG BEACH BLVD. STE 500 LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $852 | — | $852 | 5.12% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $655 | $127 | $782 | 4.70% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $228 | $63 | $291 | 1.75% |
| LAMBERT MONTALBO3 | 26197 MIRADA ST HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $214 | $41 | $255 | 1.53% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLASS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $238 | $7 | $245 | 1.47% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE WOODLAND HILLS, CA 91367 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $217 | $14 | $231 | 1.39% |
| RAYMOND KWOCKMAN GONG3 Filed as: RAYMOND GONG | 2180 FENTON PKWY SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $151 | $47 | $198 | 1.19% |
| CHARLES D SMITH3 Filed as: CHARLES D. SMITH | 4040 E. PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $183 | $11 | $194 | 1.16% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | $15 | $93 | 0.56% |
| ERIC W. SWANSON3 | 32101 FALL RIVER ROAD TRABUCO, CA 92679 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 0.52% |
| RYAN THURSTON WHITTAKER3 Filed as: RYAN T. WHITTAKER | 33011 COMMODORE CT SAN JUAN CAPISTRANO, CA 92675 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 0.46% |
| SUSAN GOLD STOKES3 Filed as: SUSAN G. STOKES | 3113 W. 187TH PLACE TORRANCE, CA 90504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.33% |
| MARIA C GONZALEZ3 Filed as: MARIA C. GONZALEZ | 11677 SANDPIPER CT MORENO VALLEY, CA 92557 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $4 | $49 | 0.29% |
| ASCENSION BENEFITS ADVISORS3 | 6 POMEGRANATE STREET LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.20% |
| UZIEL RIVERA3 | 543 CHEROKEE CIR BANNING, CA 92220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.15% |
| SADIE BLACKMON3 | 627 RAPIDS ROAD COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.13% |
| MIKE MCCORMICK3 | 29811 SANTA MARGARITA PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.13% |
| GABRIEL HOLGUIN3 | 2807 GRATTON ST. RIVERSIDE, CA 92504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.11% |
| BENEFITS COORDINATOR3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $5 | $18 | 0.11% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $10 | $17 | 0.10% |
| EDWARD J THURIN3 Filed as: EDWARD J. THURIN | 17800 BRAZIER ROAD RIVERSIDE, CA 92508 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.10% |
| JIM BARRETT3 | 8514 EAST KRAIL ST. SCOTTSDALE, AZ 85250 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GEORGE HORNE | 3410 MAGNOLIA WAY BROADVIEW HEIGHTS, OH 44147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.04% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | P. O. BOX 365 POWAY, CA 92064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| RONALD PERALEZ3 | 18 SEPULVEDA RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| BILL MUELLER3 | 7443 EADS AVE LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| CALVIN DEAN INGLE3 | 1840 LARIAT TRAIL CELINA, TX 75009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE. FLOOR 12 WOODLAND HILLS, CA 913672584 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $682 | — | $682 | 7.80% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE, INC. | 23716 BIRTCHER DR. LAKE FOREST, CA 926301771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $631 | — | $631 | 7.21% |
| MOORE ANDREW L3 Filed as: MOORE ANDREW L. | 4695 MACARTHUR CT. STE. 1000 NEWPORT BEACH, CA 926601865 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| ARMAC INSURANCE AGENCY INC3 Filed as: ARMAC INSURANCE COMPANY | 17177 YUMA STREET VICTORVILLE, CA 92392 | AMERICAN FIDELITY ASSURANCE COMPANY | $55 | — | $55 | 9.93% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 15.38% |
| CHARLES D. BLOCK3 Filed as: CHARLES DUANE SMITH | 4040 EAST PIEDMON DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 15.38% |
| RICHARD WAYNE BRYSON3 | 3777 LONG BEACH BLVD STE. 500 LONG BEACH, CA 90807 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 15.38% |
| STEPHEN W DOUGLASS3 Filed as: STEPHEN W. DOUGLASS | 45 MORNING GLORY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 3.85% |
| ADRIANA MENDIETA3 | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 3.85% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 3.85% |
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 | 634 | 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) | 634 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 589 | $3.1M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 586 | $155K |
| Vision | VISION SERVICE PLAN | 255 | $39K |
| Life insurance(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 363 | $105K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $54K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 363 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 589 | — |
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.