| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MANDELBAUM INSURANCE SERVICES LLC3 Filed as: MANDELBAUM INSURANCE SERVICES, LLC | PO BOX 480350 LOS ANGELES, CA 90048 | KAISER FOUNDATION HEALTH PLANS INC | $129K | — | $129K | 1.00% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | HEALTH NET | $21K | — | $21K | 0.98% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 900481350 | METROPOLITAN LIFE INSURANCE COMPANY | $96K | $19K | $115K | 12.07% |
| BENEFITMALL3 Filed as: BENEFITMALL HOLDING INC | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 752511800 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | — | $29K | 3.01% |
| MANDELBAUM INSURANCE SERVICES LLC | PO BOX 480350 LOS ANGELES, CA 90048 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 8.31% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | SAFEGUARD HEALTH PLANS, INC. | $10K | $2K | $12K | 12.81% |
| BENEFITMALL3 Filed as: BENEFITMALL HOLDING INC | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 752511800 | SAFEGUARD HEALTH PLANS, INC. | $3K | — | $3K | 3.08% |
| MANDELBAUM INSURANCE SERVICES LLC3 | PO BOX 480350 LOS ANGELES, CA 90048 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | — | $19K | 25.99% |
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 | 2,203 | 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) | 2,203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 154 | $2.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,568 | $1.0M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,568 | $951K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,429 | $71K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 304 | $140K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,429 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,948 | — |
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.