| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 21820 BURBANK BOULEVARD, SUITE 175 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $92K | $0 | $92K | 4.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $5K | $5K | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $22K | $0 | $22K | 8.58% |
| ANNETTE L. BURNS3 | 28303 BRYCE DRIVE CASTAIC, CA 91384 | AFLAC | $1K | $7 | $1K | 5.56% |
| MJ INSURANCE3 Filed as: BRYSTRA INS SVCS AND VARIOUS AGENTS | 1925 CENTURY PARK EAST, SUITE 1700 LOS ANGELES, CA 90067 | AFLAC | $793 | $3 | $796 | 4.24% |
| MARIA ISABEL TORRES3 | 16154 CANTLAY STREET VAN NUYS, CA 91406 | AFLAC | $310 | $7 | $317 | 1.69% |
| JAIME PUERTA3 Filed as: JAIME I. PUERTA | 28443 SANTA CATARINA ROAD SANTA CLARITA, CA 91350 | AFLAC | $209 | $0 | $209 | 1.11% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS, INC. | 11637 GORHAM AVENUE, SUITE 106 LOS ANGELES, CA 90049 | AFLAC | $163 | $0 | $163 | 0.87% |
| HORACIO J. LANZAS3 | 7032 BAIRD AVENUE RESEDA, CA 91335 | AFLAC | $116 | $3 | $119 | 0.63% |
| RUSSEL G. LAKE JR.3 | 29309 BEACHCOMBER DRIVE SUN CITY, CA 92585 | AFLAC | $102 | $0 | $102 | 0.54% |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 363 | $1.9M |
| Dental | BLUE CROSS OF CALIFORNIA | 429 | $252K |
| Vision | BLUE CROSS OF CALIFORNIA | 429 | $252K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 363 | $1.9M |
| Other | AFLAC | 2 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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.