| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIPRIMA INSURANCE SERVICES, INC.3 | 31324 VIA COLINAS-STE 111 WESTLAKE VILLAGE, CA 91362 | KAISER FOUNDATION HEALTH PLAN, INC. | $36K | — | $36K | 2.80% |
| DIPRIMA INSURANCE SERVICES, INC.3 Filed as: DIPRIMA INSURANCE SERVICE | 31324 VIA COLINAS- STE 111 WESTLAKE VILLAGE, CA 91362 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | — | $12K | 9.96% |
| DIPRIMA INSURANCE SERVICES, INC.3 | 31324 VIA COLINAS - #111 WESTLAKE VILLAGE, CA 91362 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.72% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 1.40% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | — | $6K | 11.00% |
| DIPRIMA INSURANCE SERVICES, INC.3 Filed as: DIPRIMA INSURANCE SERVICES INC. | 31324 VIA COLINAS #111 WESTLAKE VILLAGE, CA 91362 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.87% |
| DIPRIMA INSURANCE SERVICES, INC.3 | 31324 VIA COLINAS - #111 WESTLAKE VILLAGE, CA 91362 | AMERICAN FIDELITY ASSURANCE COMPANY | $805 | — | $805 | 4.71% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$307 | — | -$307 | -1.79% |
| DIPRIMA INSURANCE SERVICES, INC.3 | 31324 VIA COLINAS #111 WESTLAKE VILLAGE, CA 91362 | AMERICAN FIDELITY ASSURANCE COMPANY | $771 | — | $771 | 6.68% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$23 | — | -$23 | -0.20% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 223 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 185 | $125K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 185 | $125K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 185 | $125K |
| Short-term disability(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 44 | $174K |
| Long-term disability(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 44 | $174K |
| Other(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 44 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.