| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOGAN INSURANCE SERVICES, INC.3 | P.O. BOX 7419 THOUSAND OAKS, CA 91359 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | — | $24K | 2.86% |
| HOGAN INSURANCE SERVICES, INC.3 Filed as: HOGAN INSURANCE SERVICES INC. | P.O. BOX 7419 THOUSAND OAKS, CA 91359 | UNITED HEALTHCARE INSURANCE COMPANY | $9K | — | $9K | 5.40% |
| HOGAN INSURANCE SERVICES, INC.3 Filed as: HOGAN INSURANCE SERVICES INC. | 2801 TOWNSGATE BLVD. WESTLAKE, CA 91361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 8.99% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 121A N LOOP DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $792 | $3K | 8.82% |
| MAGNONE FINANCIAL SERVICES CORP3 Filed as: MAGNONE FINANCIAL SERVICES CORP. | 3151 OUTRIGGER AVE. VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $36 | $2K | 5.27% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $665 | $264 | $929 | 2.65% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INSURANCE ADVOCATES INC. | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $247 | $18 | $265 | 0.76% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES INC. | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 0.32% |
| RICHARD C SUTHERLAND III3 Filed as: RICHARD C. SUTHERLAND III | 3601 FIGUEROA ST GLENDALE, CA 91206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | $15 | $93 | 0.27% |
| HOGAN INSURANCE SERVICES, INC.3 Filed as: HOGAN INSURANCE SERVICES INC. | P.O. BOX 7419 THOUSAND OAKS, CA 913597419 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| HOGAN INSURANCE SERVICES, INC.3 Filed as: HOGAN INSURANCE SERVICES INC. | 2801 TOWNSGATE #133 WESTLAKE VILLAGE, CA 91361 | GOLDEN WEST HEALTH PLAN, INC. | $2K | — | $2K | 9.88% |
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 | 232 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 229 | $1.0M |
| Dental | GOLDEN WEST HEALTH PLAN, INC. | 141 | $20K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 229 | $172K |
| Life insurance(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 229 | $230K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 43 | $35K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 229 | $1.0M |
| Other(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 229 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.