| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CANINI INSURANCE MARKETING3 | P.O. BOX 1250 HUNTINGTON BEACH, CA 92647 | KAISER FOUNDATION HEALTH PLAN INC. | $47K | — | $47K | 3.50% |
| CANINI INSURANCE MARKETING3 | PO BOX1250 HUNTINGTON BEACH, CA 92647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $611 | — | $611 | 10.10% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | $32 | $99 | 1.64% |
| BENEFITS COORDINATOR3 | 10741 LA JARA ST CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $15 | $49 | 0.81% |
| CANINI INSURANCE MARKETING3 | P.O. BOX 1250 HUNTINGTON BEACH, CA 92647 | CALIFORNIA DENTAL NETWORK | $453 | — | $453 | 9.21% |
| GARNETT POWERS & ASSOCIATES INC3 Filed as: GARNETT-POWERS & ASSOCIATES | 25909 PALA, SUITE 120 MISSION VIEJO, CA 92691 | CALIFORNIA DENTAL NETWORK | $39 | — | $39 | 0.79% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 225 | $1.4M |
| Dental | CALIFORNIA DENTAL NETWORK | 31 | $5K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 155 | $6K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 225 | $1.4M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 155 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.