| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIS INSURANCE SOLUTIONS3 | 734 SILVER SPUR ROAD, SUITE 201 ROLLING HILLS ESTATES, CA 90274 | HEALTH NET | $28K | — | $28K | 4.68% |
| S AND K FINANCIAL AND INS. SVC. INC3 Filed as: S AND K FINANCIAL AND INS. SERVICES | 734 SILVER SPUR ROAD, SUITE 201 ROLLING HILLS ESTATES, CA 90274 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 4.58% |
| S AND K FINANCIAL AND INS. SVC. INC3 Filed as: S AND K FINANCIAL AND INS. SERVICES | 734 SILVER SPUR ROAD, SUITE 201 ROLLING HILLS ESTATES, CA 90274 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 5.00% |
| HANS ERIC ANDERSON3 | 6808 SAINT ESTABAN STREET TUJUNGA, CA 91042 | AFLAC | $4K | $4 | $4K | 8.22% |
| CONNIE H. SALAZAR3 Filed as: CONNIE H. SALAZAR AND OTHER AGENTS | 4952 SOUTH CALDERON MESA, AZ 85212 | AFLAC | $1K | $14 | $1K | 2.73% |
| CARLOS E. GARCIA3 | 1034 NORTH KINGSLEY DRIVE APT. 11 LOS ANGELES, CA 90029 | AFLAC | $927 | — | $927 | 2.09% |
| MARSHALL CHARLES MCDONALD3 | 905 LAKE PARK DRIVE, APARTMENT 206 DAVIDSON, NC 28036 | AFLAC | $550 | $4 | $554 | 1.25% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 265 NAOMI AVENUE ARCADIA, CA 91007 | AFLAC | $487 | — | $487 | 1.10% |
| LAURENCE H. TAYLOR3 | 1892 LAKE SHORE AVENUE LOS ANGELES, CA 90026 | AFLAC | $330 | — | $330 | 0.74% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 265 WEST NAOMI AVENUE ARCADIA, CA 91007 | AFLAC | $321 | — | $321 | 0.72% |
| HANS ERIC ANDERSON3 Filed as: HANS ANDERSON | 320 HOLSTEAD, SUITE 170 PASADENA, CA 91107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 5.31% |
| MARSHALL MCDONALD3 | 905 LAKE PARK DRIVE, APARTMENT 206 DAVIDSON, NC 28038 | CONTINENTAL AMERICAN INSURANCE COMPANY | $223 | — | $223 | 1.18% |
| KHACHATOUR MANOUKIAN3 | 928 NORTH VERDUGO ROAD GLENDALE, CA 91206 | CONTINENTAL AMERICAN INSURANCE COMPANY | $172 | — | $172 | 0.91% |
| TODD V MASON3 Filed as: TODD V. MASON | 3570 PINE AVENUE LONG BEACH, CA 90807 | CONTINENTAL AMERICAN INSURANCE COMPANY | $133 | — | $133 | 0.70% |
| MARTHA F GARCIA3 Filed as: MARTHA F. GARCIA | 4067 HARDWICK, SUITE 289 LAKEWOOD, CA 90712 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | — | $65 | 0.34% |
| JOANNA G MATHERLY3 Filed as: JOANNA G. PEOPLE | 301 MALLORY STATION ROAD, SUITE 100 FRANKLIN, TN 37607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.14% |
| MARGARET B. VAIL3 | 320 NORTH HALSTEAD PASADENA, CA 91107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.07% |
| S AND K FINANCIAL AND INS. SVC. INC3 | 734 SILVER SPUR ROAD, SUITE 201 ROLLING HILLS ESTATES, CA 90274 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| LIS INSURANCE SOLUTIONS3 | 734 SILVER SPUR ROAD, SUITE 201 ROLLING HILLS ESTATES, CA 90274 | MESVISION | $1K | — | $1K | 6.80% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 70 | $933K |
| Dental | DELTA DENTAL OF CALIFORNIA | 233 | $107K |
| Vision | MESVISION | 131 | $15K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $17K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 70 | $933K |
| Other(3 contracts, 3 carriers) | AFLAC | 167 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.