| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBSCO FINANCIAL GROUP LLC3 Filed as: LIBSCO FINANCIAL GROUP, LLC | 5 REVERE DRIVE #370 NORTHBROOK, IL 60062 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $84K | $0 | $84K | 6.13% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCIAL | 4851 LBJ FREEWAY #1100 DALLAS, TX 75244 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $13K | $13K | 0.97% |
| LIBSCO FINANCIAL GROUP LLC3 Filed as: LIBSCO FINANCIAL GROUP, LLC | 5 REVERE DR STE 370 NORTHBROOK, IL 60062 | KAISER FOUNDATION HEALTH PLAN INC. | $16K | $0 | $16K | 4.98% |
| BROKER SOURCE3 Filed as: BROKER SOURCE INC. | 11221 ROE LEAWOOD, KS 66211 | HUMANA INSURANCE COMPANY | $4K | $0 | $4K | 4.11% |
| GP RICE INSURANCE SVCS, INC.3 | 22421 BARTON RD STE 348 GRAND TERRACE, CA 92313 | DELTA DENTAL OF CALIFORNIA | $3K | $0 | $3K | 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 | 385 | 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) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 73 | $325K |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 148 | $136K |
| Vision | KAISER FOUNDATION HEALTH PLAN INC. | 73 | $325K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 299 | $1.4M |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 299 | $1.4M |
| Other | HUMANA INSURANCE COMPANY | 13 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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.