| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INS. SVCS., LLC3 Filed as: BENEFITS AMERICA INS. SERVICES LLC | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC | $18K | $0 | $18K | 3.70% |
| J.D. GILMOUR & CO., INC.3 Filed as: J.D. GILMOUR AND COMPANY INC. | 300 WEST GLENOAKS BOULEVARD SUITE 301 GLENDALE, CA 91202 | CALIFORNIA PHYSICIANS SERVICE | $0 | $18K | $18K | 5.31% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, SUITE 1200 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 15.00% |
| JOHN M. GILMOUR, INC.3 Filed as: JOHN M. GILMOUR INC. | 300 WEST GLENOAKS BOULEVARD SUITE 301 GLENDALE, CA 91202 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $974 | $0 | $974 | 11.08% |
| BENEFITS AMERICA INS. SVCS., LLC3 Filed as: BENEFITS AMERICA INS. SERVICES, LLC | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $267 | $0 | $267 | 10.72% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 71 | $810K |
| Dental | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | 59 | $9K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 30 | $2K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 106 | $25K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 106 | $25K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 71 | $810K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 106 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.