| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | KAISER FOUNDATION HEALTH PLAN INC. | $54K | — | $54K | 5.42% |
| CENTENNIAL GROUP BENEFITS3 | 1500 QUAIL STREET, SUITE 100 NEWPORT BEACH, CA 92660 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $1K | $6K | 7.52% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $415 | — | $415 | 3.25% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $13 | $13 | 0.10% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | GOLDEN WEST HEALTH PLAN, INC. | $937 | — | $937 | 11.60% |
| PARKER E. LYONS3 | 2021 BUSINESS CENTER DRIVE, STE 205 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $822 | — | $822 | 13.73% |
| CENTENNIAL GROUP BENEFITS3 | 1500 QUAIL STREET, SUITE 100 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $487 | — | $487 | 10.00% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 26457 SANTA ANA, CA 92799 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $174 | — | $174 | 4.77% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DR. TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $383 | — | $383 | 13.72% |
| MARIA SCHWARTZ4 | 312 VIA PROMESA SAN CLEMENTE, CA 92673 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $31 | — | $31 | 1.11% |
| CENTENNIAL GROUP BENEFITS3 | 1500 QUAIL STREET, SUITE 100 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $31 | — | $31 | 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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 179 | $991K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 103 | $85K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 103 | $77K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 209 | $6K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 14 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 209 | $5K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 179 | $991K |
| Other(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 209 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.