| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALEXANDER SHEININ3 | 301 NORTH CANON DRIVE #226 BEVERLY HILLS, CA 90210 | BLUE CROSS OF CALIFORNIA | $63K | — | $63K | 4.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMINISTRATO | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $25K | $25K | 2.00% |
| CDS INSURANCE SERVICES3 Filed as: CDS CORP | 2001 EAST FINANCIAL WAY SUITE 200 GLENDORA, CA 91741 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $7K | — | $7K | 1.99% |
| ALEXANDER SHEININ3 | 301 NORTH CANON DRIVE SUITE 226 BEVERLY HILLS, CA 90210 | PRINCIPAL LIFE INSURANCE COMPANY | $31K | — | $31K | 13.07% |
| ALDA R DEARMOND3 | 1693 SOUTH SPRING VALLEY LANE SUITE 200 MERIDIAN, ID 83642 | REGENCE BLUESHIELD OF IDAHO, INC. | $324 | $30 | $354 | 2.97% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVENUE SUITE 201 CLIFTON, NJ 07013 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.00% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVENUE SUITE 201 CLIFTON, NJ 07013 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $660 | — | $660 | 14.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SE | PO BOX 255387 SACRAMENTO, CA 95865 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $298 | $87 | $385 | 9.69% |
| CDS INSURANCE SERVICES3 Filed as: CDS CORP DBA CDS INSURANCE SER | 2001 EAST FINANCIAL WAY SUITE 200 GLENDORA, CA 91741 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $298 | — | $298 | 7.50% |
| WILLNER-CARDINET-KIDWELL3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.15% |
| GROUP ADVISORY INC3 | 1135 CLIFTON AVENUE SUITE 201 CLIFTON, NJ 07013 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $137 | — | $137 | 14.96% |
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 | 189 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 219 | $1.6M |
| Dental(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 180 | $603K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $239K |
| Life insurance(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 328 | $259K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 7 | $916 |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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.