| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TOLMAN AND WIKER INS. SVCS., LLC3 | PO BOX 1388 VENTURA, CA 93002 | BLUE CROSS OF CALIFORNIA | $43K | — | $43K | 3.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 EAST CARMEL DRIVE, SUITE 400 CARMEL, IN 46032 | BLUE CROSS OF CALIFORNIA | $8K | — | $8K | 0.69% |
| TOLMAN AND WIKER INS. SVCS., LLC3 | PO BOX 1388 VENTURA, CA 93002 | KAISER FOUNDATION HEALTH PLAN INC | $20K | — | $20K | 1.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 0.55% |
| TOLMAN AND WIKER INS. SVCS., LLC3 | 196 SOUTH FIR STREET VENTURA, CA 93002 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 9.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN CALABASAS, CA 91302 | DELTA DENTAL OF CALIFORNIA | $298 | — | $298 | 0.76% |
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 | 292 | 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) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 238 | $2.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 100 | $39K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 238 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.