| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 175 S. SAN ANTONIO ROAD, SUITE 101 LOS ALTOS, CA 940223748 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 2.98% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 175 S. SAN ANTONIO ROAD, SUITE 101 LOS ALTOS, CA 940223748 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 3.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | UNION SECURITY INSURANCE COMPANY | $6K | $9K | $14K | 10.11% |
| KEVIN MICHAEL NAGLE3 Filed as: KEVIN M. NAGEL | 1048 14TH STREET SUITE 101 SANTA MONICA, CA 90403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $555 | — | $555 | 1.74% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | CONTINENTAL AMERICAN INSURANCE COMPANY | $446 | — | $446 | 1.40% |
| MICHELLE L RAMSOUER3 Filed as: MICHELLE L. RAMSOUER | PO BOX 1394 GEORGE WEST, TX 78022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $373 | — | $373 | 1.17% |
| MICHAEL J. RINKE3 | 7349 PONCE AVENUE WEST HILLS, CA 91307 | CONTINENTAL AMERICAN INSURANCE COMPANY | $364 | — | $364 | 1.14% |
| L MATTHEW SPALDING3 Filed as: MATTHEW L. SPALDING | 4297 KLUME AVENUE SUITE 204 STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $289 | — | $289 | 0.91% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $196 | — | $196 | 0.62% |
| SHIRLEY S. HAGER3 | 1930 BARRY AVENUE LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $148 | — | $148 | 0.46% |
| OSCAR R. RIVERA3 | 4639 CORONA SUITE 34 CORPUS CHRISTI, TX 78411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $140 | — | $140 | 0.44% |
| BRENDA R. MATUTE3 | 7125 LENNOX AVENUE SUITE 239 VAN NUYS, CA 91405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $133 | — | $133 | 0.42% |
| TIMOTHY W. PETERSON3 | 106 NORTH FLORES STREET LOS ANGELES, CA 90048 | CONTINENTAL AMERICAN INSURANCE COMPANY | $44 | — | $44 | 0.14% |
| CHRISTOPHER HAGER3 | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $41 | — | $41 | 0.13% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO | 9018 BALBOA BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | CONTINENTAL AMERICAN INSURANCE COMPANY | $39 | — | $39 | 0.12% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 N. HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | — | $30 | 0.09% |
| STEVEN GOLDSTEIN3 | 6255 VENTURA CANYON VALLEY GLEN, CA 91401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.03% |
| NANCY C. CANO3 | 735 N. HILL AVENUE PASADENA, CA 91104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 25 FALCON HILLS DRIVE HIGHLANDS RANCH, CO 80126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | UDC DENTAL OF CALIFORNIA, INC. | — | $775 | $775 | 6.75% |
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 | 517 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 519 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 314 | $2.5M |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 177 | $151K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 82 | $32K |
| Prescription drug(6 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 314 | $2.5M |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 82 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.