| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIXME INSURANCE SOLUTIONS, INC.3 Filed as: HIXME INSURANCE SOLUTIONS INC | 27489 AGOURA RD SUITE 100 AGOURA HILLS, CA 91301 | KAISER FOUNDATION HEALTH PLAN INC. | $689 | $0 | $689 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP, A MARSH AND MCLENNAN | AGENCY, LLC 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $31K | $0 | $31K | 4.13% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP, A MARSH AND MCLENNAN | AGENCY, LLC 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $448 | $5K | $5K | 2.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP, A MARSH AND MCLENNAN | AGENCY, LLC 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $279 | $3K | $3K | 2.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP, A MARSH AND MCLENNAN | AGENCY, LLC 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $4K | $325 | $4K | 4.32% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 2.78% |
| KARR, TINA, LESLEE3 | 26045 MAGDALENA DR VALENCIA, CA 91353 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $977 | $0 | $977 | 1.05% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY GROUP BENEFITS | 2850 W HORIZON E RIDGE PKWY SUITE 200 HENDERSON, NV 89052 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $739 | $0 | $739 | 0.80% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $200 | $0 | $200 | 0.22% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP, A MARSH AND MCLENNAN | AGENCY, LLC 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $207 | $1K | 1.97% |
| KARR, TINA, LESLEE3 | 26045 MAGDALENA DR VALENCIA, CA 91353 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $644 | $0 | $644 | 1.04% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY GROUP BENEFITS | 2850 W HORIZON E RIDGE PKWY SUITE 200 HENDERSON, NV 89052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $393 | $0 | $393 | 0.63% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $151 | $0 | $151 | 0.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: TRION GROUP, A MARSH AND MCLENNAN | AGENCY, LLC 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | VISION SERVICE PLAN | $799 | $0 | $799 | 3.21% |
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 | 978 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 985 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 661 | $6.2M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 514 | $598K |
| Vision(2 contracts) | VISION SERVICE PLAN | 576 | $93K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 978 | $454K |
| Short-term disability | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | 251 | $93K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 978 | $228K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 661 | $6.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 978 | $424K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 978 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.