| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | DEPARTMENT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23K | $1K | $24K | 11.93% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 9.15% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 18201 VON KARMAN AVENUE SUITE 1020 IRVINE, CA 92612 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $7K | $12K | 6.02% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.27% |
| WILLIAM P HOFTO3 | 2910 NEILSON WAY, UNIT 410 SANTA MONICA, CA 90405 | AFLAC | $717 | — | $717 | 5.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE AND VARIOUS AGENTS | 21600 OXNARD STREET, 8TH FLOOR WOODLAND HILLS, CA 91367 | AFLAC | $466 | — | $466 | 3.64% |
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP, INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | AFLAC | $336 | — | $336 | 2.62% |
| BETTY MURDOCK3 | 2980 FLORINE AVENUE RIVERSIDE, CA 92509 | AFLAC | $307 | — | $307 | 2.40% |
| MOMENTUS INSURANCE BROKERAGE, INC.3 | 5805 SEPULVEDA BOULEVARD SUITE 740 SHERMAN OAKS, CA 91411 | AFLAC | $276 | — | $276 | 2.16% |
| BRIAN G JAEGGI3 | 5112 TOPANGA CANYON BOULEVARD WOODLAND HILLS, CA 91364 | AFLAC | $109 | — | $109 | 0.85% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVENUE BELLFLOWER, CA 90706 | AFLAC | $87 | — | $87 | 0.68% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 283 | $2.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 156 | $199K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 156 | $199K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 156 | $402K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 153 | $147K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 153 | $134K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 283 | $2.0M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 156 | $415K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.