| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CA INS SVCS | 1300 DOVE STREET, SUITE 300 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $30K | $0 | $30K | 4.01% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVCS., LLC | 2677 NORTH MAIN STREET, SUITE 800 SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $0 | $16K | $16K | 2.07% |
| COMMERCIAL INSURANCE ASSOCIATES3 | 103 POWELL STREET, SUITE 200 BRENTWOOD, TN 37027 | BLUE CROSS OF CALIFORNIA | $7K | $0 | $7K | 0.97% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 435 WHITTINGTON PARKWAY, SUITE 300 LOUISVILLE, KY 40222 | BLUE CROSS OF CALIFORNIA | $0 | $1K | $1K | 0.14% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF COLORADO, LLC | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | $0 | $15K | 2.93% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $0 | $9K | 1.78% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS CAPITAL, INC. | PO BOX 1388 VENTURA, CA 93002 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | $0 | $8K | 1.63% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF COLORADO, LLC | 2002 CARIBOU DRIVE, SUITE 101 FORT COLLINS, CO 80525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $11K | 11.52% |
| COMMERCIAL INSURANCE ASSOCIATES3 | 103 POWELL COURT, SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.04% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2 ENTERPRISE DRIVE, SUITE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.05% |
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 | 147 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 196 | $1.3M |
| Dental | BLUE CROSS OF CALIFORNIA | 196 | $758K |
| Vision | BLUE CROSS OF CALIFORNIA | 196 | $758K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $97K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $97K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $97K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 196 | $1.3M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 196 | $855K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.