| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 21011 WARNER CENTER LANE WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $81K | $0 | $81K | 4.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE ALMADEN BOULEVARD SUITE 960 SAN JOSE, CA 95113 | HUMANADENTAL INSURANCE COMPANY | $21K | $0 | $21K | 9.96% |
| ANNETTE L. BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $3K | $54 | $3K | 6.12% |
| RUSSELL G LAKE JR3 Filed as: RUSSELL G. LAKE, JR | 29309 BEACHCOMBER DRIVE SUN CITY, CA 92585 | AFLAC | $2K | $0 | $2K | 4.42% |
| LAURA CORRAL3 | 1211 SOUTH CATALINA STREET, SUITE 1 LOS ANGELES, CA 90006 | AFLAC | $1K | $0 | $1K | 2.02% |
| JACOB BURNS INC.3 Filed as: JACOB M. BURNS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $617 | $22 | $639 | 1.29% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON, JR. | 711 SOUTH OLIVE STREET, SUITE 314 LOS ANGELES, CA 90014 | AFLAC | $385 | $22 | $407 | 0.82% |
| JAIME PUERTA3 Filed as: JAIME I. PUERTA | 12121 WILSHIRE BOULEVARD SUITE 1225 LOS ANGELES, CA 90025 | AFLAC | $347 | $54 | $401 | 0.81% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS, INC. | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $355 | $0 | $355 | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | $0 | $1K | 9.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $639 | $639 | 4.32% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 315 | $1.7M |
| Dental | HUMANADENTAL INSURANCE COMPANY | 180 | $211K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 206 | $15K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 315 | $1.7M |
| Other | AFLAC | 69 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.