| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 400 GALLERIA PARKEAY, SUITE 300 ATLANTA, GA 30339 | BLUE CROSS OF CALIFORNIA | $88K | — | $88K | 14.84% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $1K | $8K | 4.92% |
| KEVIN MICHAEL NAGLE3 Filed as: KEVIN M. NAGEL | 1048 14TH STREET SUITE 101 SANTA MONICA, CA 90403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $337 | — | $337 | 2.37% |
| BRENDA R. MATUTE3 | 7125 LENNOX AVENUE SUITE 239 VAN NUYS, CA 91405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $256 | — | $256 | 1.80% |
| MICHAEL J. RINKE3 | 7349 PONCE AVENUE WEST HILLS, CA 91307 | CONTINENTAL AMERICAN INSURANCE COMPANY | $160 | — | $160 | 1.13% |
| LABAN M. SPALDING3 | 4297 KLUME AVENUE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $129 | — | $129 | 0.91% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | CONTINENTAL AMERICAN INSURANCE COMPANY | $126 | — | $126 | 0.89% |
| MICHELLE L RAMSOUER3 Filed as: MICHELLE L. RAMSOUER | PO BOX 1394 GEORGE WEST, TX 78022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $126 | — | $126 | 0.89% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $81 | — | $81 | 0.57% |
| SHIRLEY S. HAGER3 | 1930 BARRY AVENUE LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $68 | — | $68 | 0.48% |
| STEVEN GOLDSTEIN3 | 6255 VENTURA CANYON VALLEY GLEN, CA 91401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.42% |
| MICHAEL R. FISHER3 | 50 W. LEMON AVENUE SUITE 2 MONROVIA, CA 91016 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.17% |
| TIMOTHY W. PETERSON3 | 106 NORTH FLORES STREET LOS ANGELES, CA 90048 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | — | $23 | 0.16% |
| CHRISTOPHER HAGER3 Filed as: CHRISTOPHER A. HAGER | 8201 PARK HILL DRIVE LOS ANGELES, CA 90045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.11% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZELLO | 9018 BALBOA BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.11% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 N. HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.08% |
| MICHELLE C. LEE3 | 1 SOUTH FAIR OAKS AVENUE SUITE 200 PASADENA, CA 91006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| NANCY C. CANO3 | 735 N. HILL AVENUE PASADENA, CA 91104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| DANIEL E ELLIS3 Filed as: DANIEL E. ELLIS | 349 E. CALIFORNIA BOULEVARD PASADENA, CA 91106 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| ELIZABETH A LENZO3 Filed as: ELIZABETH A. LENZO | 349 E. CALIFORNIA BOULEVARD PASADENA, CA 91106 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | — | $9 | $9 | 0.11% |
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 | 706 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 707 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 35 | $390K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 214 | $167K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 84 | $14K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 35 | $390K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS OF CALIFORNIA | 644 | $594K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 84 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 644 | — |
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.