| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | KAISER FOUNDATION HEALTH PLAN INC | $42K | $0 | $42K | 5.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $2K | $2K | 0.25% |
| MYKISHA L. THOMAS3 | 607 EAST 67TH STREET, APARTMENT 4 INGLEWOOD, CA 90302 | AFLAC | $4K | $283 | $4K | 12.77% |
| MJ INSURANCE3 Filed as: STEVEN JOHNSON AND VARIOUS AGENTS | 6167 BRISTOL PARKWAY, SUITE 106 CULVER CITY, CA 90230 | AFLAC | $617 | $7 | $624 | 1.85% |
| TALHA ZAQUIR RAHMAN3 | 20336 ANZA AVENUE, APARTMENT 36 TORRANCE, CA 90503 | AFLAC | $504 | $73 | $577 | 1.71% |
| DAVID HERNANDEZ3 | 1160 EAST MARIPOSA AVENUE EL SEGUNDO, CA 90245 | AFLAC | $418 | $0 | $418 | 1.24% |
| EMERALD SHAREE AUSTIN3 | 4445 ATLANTIC AVENUE, APARTMENT 4 LONG BEACH, CA 90807 | AFLAC | $277 | $81 | $358 | 1.06% |
| NURDEEN ABIMBOLA SALAMI3 | 756 WEST 173RD PLACE GARDENA, CA 90247 | AFLAC | $239 | $0 | $239 | 0.71% |
| OSCAR RAFAEL PUENTE3 | 126 EAST 85TH STREET LOS ANGELES, CA 90003 | AFLAC | $229 | $0 | $229 | 0.68% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 136 | $781K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $0 |
| Vision | VISION SERVICE PLAN | 136 | $0 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 136 | $0 |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 136 | $34K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 136 | $0 |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 136 | $781K |
| Other(2 contracts, 2 carriers) | AFLAC | 136 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.