| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA PARK, SUITE 1200 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC. | $40K | — | $40K | 3.28% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 0.67% |
| DONALD W TAPERT INS AGCY INC3 Filed as: DONALD W TAPERT INS AGENCY INC | 14 N BALDWIN AVENUE SIERRA MADRE, CA 91024 | CALIFORNIA PHYSICIANS SERVICE | $28K | — | $28K | 4.60% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | $8K | — | $8K | 1.28% |
| BENEFITS AMERICA INS. SVCS., LLC3 Filed as: BENEFITS AMERICA INS SVCS LLC | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | -$4K | $312 | -$3K | -0.53% |
| TAPERT INSURANCE AGENCY3 | 14 N. BALDWIN AVENUE SIERRA MADRE, CA 91024 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 8.06% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 1.94% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $10K | $20 | $10K | 26.46% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA PARK, SUITE 1200 WOODLAND HILLS, CA 91367 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $493 | $3K | 9.83% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $286 | $115 | $401 | 1.33% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA PARK, SUITE 1200 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 11.29% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $885 | — | $885 | 3.71% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | CALIFORNIA DENTAL NETWORK | $2K | — | $2K | 10.00% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA PARK, SUITE 1200 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $630 | — | $630 | 10.86% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IR, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $240 | — | $240 | 4.14% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA PARK, SUITE 1200 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $472 | — | $472 | 11.65% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $136 | — | $136 | 3.36% |
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 | 279 | 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) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 283 | $1.9M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 145 | $137K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 420 | $30K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 285 | $30K |
| Short-term disability | AFLAC | 71 | $36K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $4K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 283 | $1.8M |
| Other(3 contracts, 2 carriers) | AFLAC | 285 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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.