| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 0.15% |
| HAMMAN MILLER BEAUCHAMP DEEBLE3 | 3633 E. BROADWAY LONG BEACH, CA 90803 | CALIFORNIA PHYSICIANS SERVICE | $44K | — | $44K | 5.00% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | $27K | — | $27K | 3.12% |
| HAMMAN MILLER BEAUCHAMP DEEBLE3 | 3633 E. BROADWAY LONG BEACH, CA 90803 | HUMANA, INC. | $5K | $223 | $5K | 4.22% |
| HAMMAN MILLER BEAUCHAMP DEEBLE3 | 3633 E. BROADWAY LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| JOHN KUNZ3 | 5805 SEPULVEDA BLVD. SHERMAN OAKS, CA 91411 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| HAMMAN MILLER BEAUCHAMP DEEBLE3 | 3633 E. BROADWAY LONG BEACH, CA 90803 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $801 | — | $801 | 11.01% |
| JOHN KUNZ3 | 5805 SEPULVEDA BLVD. SHERMAN OAKS, CA 91411 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $364 | — | $364 | 5.00% |
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 | 189 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 128 | $1.8M |
| Dental | HUMANA, INC. | 136 | $116K |
| Vision | HUMANA, INC. | 136 | $116K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 189 | $28K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 128 | $1.8M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 189 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.