| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY BENEFIT INSURANCE SERVICES | 2850 W.HORIZON RIDGE PKWY, #200 HENDERSON, NV 89052 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $143K | $42 | $143K | 3.15% |
| AFFINITY GROUP BENEFITS LLC3 | 3615 OLD CONEJO ROAD NEWBURY PARK, CA 91320 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 1.83% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY GROUP BENEFITS, LLC | 3615 OLD CONEJO ROAD NEWBURY PARK, CA 91320 | KAISER FOUNDATION HEALTH PLAN INC. | $16K | — | $16K | 1.83% |
| AFFINITY GROUP BENEFITS LLC3 | 2945 TOWNSGATE ROAD-SUITE 200 WESTLAKE VILLAGE, CA 91361 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 4.43% |
| AFFINITY GROUP BENEFITS LLC3 Filed as: AFFINITY GROUP BENEFITS, LLC | 2945 TOWNSGATE ROAD - SUITE 200 WESTLAKE VILLAGE, CA 91361 | VISION SERVICE PLAN | $2K | — | $2K | 3.81% |
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 | 495 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 502 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 400 | $6.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 400 | $4.6M |
| Vision | VISION SERVICE PLAN | 404 | $48K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 495 | $275K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 495 | $275K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 495 | $275K |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 620 | $338K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 620 | — |
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."
No prospect flags tripped on this filing.