| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $53K | $0 | $53K | 5.51% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $599 | $599 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $5K | $0 | $5K | 6.31% |
| MJ INSURANCE3 Filed as: PAUL KIRTON JR. AND VARIOUS AGENTS | 5520 WILSHIRE BOULEVARD, SUITE 727 LOS ANGELES, CA 90036 | AFLAC | $3K | $203 | $3K | 4.36% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $3K | $154 | $3K | 4.26% |
| CECILIA CALLEROS GOMEZ3 | 11271 WHITEWATER AVENUE MONTCLAIR, CA 91763 | AFLAC | $2K | $471 | $2K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2K | $0 | $2K | 2.30% |
| JONATHAN ALI HAJIMOMEN3 | 1561 EAST ORANGETHORPE AVENUE SUITE 200 FULLERTON, CA 92831 | AFLAC | $1K | $154 | $2K | 2.21% |
| CECILIA CALLEROS GOMEZ3 | 328 NORTH CLINTON STREET ORANGE, CA 92867 | AFLAC | $2K | $0 | $2K | 2.20% |
| LUZ CASTILLO BARRIGA3 Filed as: LUZ C. BARRIGA | 22019 JUAN AVENUE HAWAIIAN GARDENS, CA 90716 | AFLAC | $1K | $0 | $1K | 1.71% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 169 | $955K |
| Dental | BLUE CROSS OF CALIFORNIA | 163 | $71K |
| Vision | BLUE CROSS OF CALIFORNIA | 163 | $71K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 169 | $955K |
| Other | AFLAC | 85 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.