| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTELLIBENEFITS INSURANCE SERVICES3 Filed as: INTELLIBENEFITS INS SERVICES, INC. | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | KAISER FOUNDATION HEALTH PLAN, INC. | $74K | $0 | $74K | 5.03% |
| INTELLIBENEFITS INSURANCE SERVICES3 Filed as: INTELLIBENEFITS INS SERVICES, INC. | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | HEALTH NET | $16K | $0 | $16K | 7.74% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 9.02% |
| KRISTIN LEASE3 | 3890 HOWARD AVENUE LOS ALAMITOS, CA 90720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $3K | $4K | 6.29% |
| INTELLIBENEFITS INSURANCE SERVICES3 | 2522 CHAMBERS ROAD, SUITE 121 TUSTIN, CA 92780 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 4.77% |
| RAYMOND J DICK3 Filed as: RAYMOND J. DICK | 108 VALLEY CREEK COURT FRANKLIN, TN 37064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.78% |
| MAIRA MAGALI ORTIZ3 | 43642 35TH STREET EAST LANCASTER, CA 93535 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $132 | $2K | 2.91% |
| AMERICAN D. ESPINOSA & OTHER AGENTS3 | 687 HELEN DRIVE UNIT 2 OCEANSIDE, CA 92057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $221 | $2K | 2.73% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $166 | $2K | 2.42% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $379 | $1K | 2.21% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 178 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 162 | $148K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 162 | $148K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 162 | $211K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 162 | $211K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 178 | $1.7M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 162 | $211K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.