| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POMS AND ASSOCIATES INS. BROKERS3 Filed as: POMS & ASSOC INSURANCE BROKERS | 5700 CANOGA AVE SUITE 400 WOODLAND HILLS, CA 91367 | AETNA HEALTH OF CALIFORNIA, INC. | $16K | — | $16K | 3.69% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 5700 CANOGA AVENUE STE 400 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $21K | — | $21K | 4.98% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 5700 CANOGA AVE SUITE 400 WOODLAND HILLS, CA 91367 | UNION SECURITY INSURANCE COMPANY | $4K | $18 | $4K | 10.04% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 5700 CANOGA AVE STE 400 WOODLAND HILLS, CA 91367 | THE PRUDENTIAL INS CO OF AMERICA | $3K | — | $3K | 9.97% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | THE PRUDENTIAL INS CO OF AMERICA | — | $51 | $51 | 0.17% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 5700 CANOGA AVE STE 400 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE CO. | $572 | $445 | $1K | 7.07% |
| POMS & ASSOCIATES INSURANCE BROKERS3 | 5700 CANOGA AVE STE 400 WOODLAND HILLS, CA 91367 | UDC DENTAL OF CALIFORNIA INC | $1K | — | $1K | 10.00% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 70 | $54K |
| Life insurance(2 contracts, 2 carriers) | THE PRUDENTIAL INS CO OF AMERICA | 138 | $45K |
| Other | THE PRUDENTIAL INS CO OF AMERICA | 138 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.