| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HNBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | BLUE CROSS OF CALIFORNIA | $64K | — | $64K | 4.97% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE CROSS OF CALIFORNIA | — | $26K | $26K | 2.01% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 4.31% |
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | PREMIER ACCESS INSURANCE COMPANY | $6K | — | $6K | 4.90% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | PREMIER ACCESS INSURANCE COMPANY | $4K | — | $4K | 3.15% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 12.32% |
| HMBD INSURANCE SERVICES3 | 3633 E. BROADWAY, SUITE 200 LONG BEACH, CA 90803 | COPOWER LANDMARK | $148 | — | $148 | 10.02% |
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 | 192 | 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) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 200 | $1.5M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 187 | $119K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 192 | $56K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 192 | $56K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 200 | $1.5M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 192 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.