| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALEXANDER SHEININ3 | 301 NORTH CANON DRIVE SUITE 226 BEVERLY HILLS, CA 90210 | HEALTH NET | $32K | — | $32K | 4.00% |
| CDS INSURANCE SERVICES3 Filed as: CDS CORP | 2001 EAST FINANCIAL WAY SUITE 200 GLENDORA, CA 91741 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | — | $5K | 1.97% |
| ALEXANDER SHEININ3 | 301 NORTH CANON DRIVE SUITE 226 BEVERLY HILLS, CA 90210 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 10.08% |
| ALDA R DEARMOND3 | 1693 SOUTH SPRING VALLEY LANE SUITE 200 MERIDIAN, ID 83642 | REGENCE BLUESHIELD OF IDAHO | $1K | — | $1K | 3.78% |
| ALEXANDER SHEININ3 | 301 NORTH CANON DRIVE SUITE 226 BEVERLY HILLS, CA 90210 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | — | $2K | 10.30% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVENUE SUITE 201 CLIFTON, NJ 07013 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $923 | — | $923 | 10.00% |
| DEBRA R PICKETT3 | 79440 CORPARATE CENTER DRIVE SUITE 115 LA QUINTA, CA 92253 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $204 | — | $204 | 7.51% |
| CDS INSURANCE SERVICES3 Filed as: CDS CORP DBA CDS INSURANCE SERVICE | 2001 EAST FINANCIAL WAY SUITE 200 GLENDORA, CA 91741 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $204 | — | $204 | 7.51% |
| WILLNER-CARDINET-KIDWELL3 | 333 NORTH INDIAN HILL BOULEVARD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4 | — | $4 | 0.15% |
| WILLNER-CARDINET-KIDWELL3 | 333 NORTH INDIAN HILL BOULEVARD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4 | — | $4 | 0.15% |
| INSURE IDAHO LLC3 | 1693 SOUTH SPRING VALLEY LANE SUITE 200 MERIDIAN, ID 83642 | LIFEMAP ASSURANCE COMPANY | $112 | — | $112 | 10.04% |
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 | 228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTH NET | 200 | $1.1M |
| Dental(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 134 | $449K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 104 | $148K |
| Life insurance(4 contracts, 4 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 265 | $161K |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 265 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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."
No prospect flags tripped on this filing.