| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVA INSURANCE SOLUTIONS3 | 1930 S. BREA CANYON SUITE 200 DIAMOND BAR, CA 91765 | CALIFORNIA PHYSICIANS SERVICE | $199 | $1.1M | $1.1M | 5.26% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON RD STE 200 DIAMOND BAR, CA 917654011 | KAISER FOUNDATION HEALTH PLAN INC | $116K | — | $116K | 3.66% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON ROAD STE 200 DIAMOND BAR, CA 917659176 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $122K | — | $122K | 6.89% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON ROAD STE 200 DIAMOND BAR, CA 917654011 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $44K | — | $44K | 10.00% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON ROAD STE 200 DIAMOND BAR, CA 917654011 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $43K | — | $43K | 10.00% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON ROAD STE 200 DIAMOND BAR, CA 917654011 | VISION SERVICE PLAN | $23K | — | $23K | 10.52% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON ROAD SUITE 200 DIAMOND BAR, CA 917654011 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $5K | — | $5K | 6.29% |
| INNOVA INSURANCE3 | 1930 S. BREA CANYON ROAD STE 200 DIAMOND BAR, CA 917654011 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $493 | — | $493 | 2.74% |
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 | 2,658 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 658 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | CALIFORNIA PHYSICIANS SERVICE | 2,949 | $25.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,935 | $1.8M |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,935 | $2.0M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,935 | $1.8M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,366 | $429K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,658 | $438K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 2,949 | $21.7M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 2,935 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,949 | — |
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.