| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC. | $37K | — | $37K | 3.62% |
| TAPERT INSURANCE AGENCY3 | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.71% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $19K | $360 | $20K | 4.07% |
| TAPERT INSURANCE AGENCY3 | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.04% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $395 | $8K | 24.60% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $857 | — | $857 | 6.59% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | HOLMAN FAMILY COUNSELING CENTERS | $461 | — | $461 | 5.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $823 | — | $823 | 15.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $587 | — | $587 | 15.01% |
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 | 264 | 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) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 240 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 107 | $70K |
| Vision | VISION SERVICE PLAN | 161 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 283 | $19K |
| Short-term disability | AFLAC | 63 | $34K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $4K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 240 | $1.5M |
| Other(4 contracts, 3 carriers) | AFLAC | 397 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.