| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE SUITE 204 SHERMAN OAKS, CA 91423 | KAISER FOUNDATION HEALTH PLAN INC. | $42K | $0 | $42K | 4.61% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE SUITE 204 SHERMAN OAKS, CA 91423 | HEALTH NET | $40K | $0 | $40K | 4.81% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE SUITE 204 SHERMAN OAKS, CA 91423 | UNITED CONCORDIA INSURANCE COMPANY | $16K | $0 | $16K | 10.02% |
| ARROYO INSURANCE SERVICES, INC.3 | 440 EAST HUNTINGTON DRIVE SUITE 100 ARCADIA, CA 91006 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 12.26% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE SHERMAN OAKS, CA 91423 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | $0 | $2K | 2.51% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 290 TECHNOLOGY DRIVE SUITE 100 IRVINE, CA 91367 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $134 | $0 | $134 | 0.14% |
| ARROYO INSURANCE SERVICES, INC.3 | 13749 RIVERSIDE DRIVE SUITE 204 SHREMAN OAKS, CA 91423 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $0 | $2K | 9.91% |
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 | 205 | 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) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 139 | $1.8M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 215 | $172K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 242 | $105K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 242 | $105K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 242 | $105K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 242 | $105K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 139 | $1.8M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 242 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.