| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | CALIFORNIA PHYSICIANS SERVICE | $70K | $1K | $71K | 5.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $38K | — | $38K | 4.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PRINCIPAL LIFE INSURANCE COMPANY | $20K | $1K | $21K | 10.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | CALIFORNIA DENTAL NETWORK, INC. | $3K | — | $3K | 10.00% |
| EDWARD S. RICE JR.3 | 4050 KATELLA AVENUE, SUITE 213 LOS ALAMITOS, CA 90720 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $324 | — | $324 | 3.18% |
| MARK KIM3 | 20895 GOLDEN SPRINGS WALNUT, CA 91789 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $271 | — | $271 | 2.66% |
| WENNDY R. CORTEZ3 | 3133 LANIER DRIVE SAN CLEMENTE, CA 92674 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | — | $20 | 0.20% |
| ROBERT A. CORLETTE3 | 1015 NORTH RIDGLINE ROAD ORANGE, CA 92869 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.13% |
| MJ INSURANCE3 Filed as: EDGAR AGUILAR AND VARIOUS AGENTS | PO BOX 4108 SAN CLEMENTE, CA 92674 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.13% |
| DUANE M. BAUTISTA3 Filed as: DUANE BAUTISTA | 6 CANDLEWOOD LANE ALISO VIEJO, CA 92656 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.13% |
| ART VARTAN KASABIAN3 | 2110 SOUTH JACOB STREET VISALIA, CA 93277 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | — | $12 | 0.12% |
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 | 256 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 271 | $2.3M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $232K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 271 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $215K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 271 | $2.2M |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 401 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.