| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | KAISER FOUNDATION HEALTH PLAN INC | $32K | $5K | $37K | 3.45% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | UNION SECURITY INSURANCE COMPANY | $12K | — | $12K | 10.88% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | UNION SECURITY INSURANCE COMPANY | $7K | — | $7K | 10.86% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | UNION SECURITY INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | UDC DENTAL OF CALIFORNIA INC. | $2K | — | $2K | 10.00% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | UNION SECURITY INSURANCE COMPANY | $628 | — | $628 | 5.00% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | UDC DENTAL OF CALIFORNIA INC. | $981 | — | $981 | 10.01% |
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 | 217 | 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) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 166 | $1.1M |
| Dental(4 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 102 | $200K |
| Vision(2 contracts) | UNION SECURITY INSURANCE COMPANY | 102 | $35K |
| Life insurance(2 contracts) | UNION SECURITY INSURANCE COMPANY | 102 | $173K |
| Short-term disability(2 contracts) | UNION SECURITY INSURANCE COMPANY | 102 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.