| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | — | $32K | 5.84% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | — | $18K | 5.74% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | $1K | $12K | 4.32% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $5K | 10.35% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | VISION SERVICE PLAN | $4K | — | $4K | 9.67% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 11.64% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 10.06% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $786 | $3K | $4K | 21.61% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $627 | $1K | $2K | 12.59% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $445 | $939 | $1K | 14.46% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | MUTUAL OF OMAHA INSURANCE COMPANY | $273 | — | $273 | 4.67% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METLIFE LEGAL PLANS | $562 | — | $562 | 11.22% |
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 | 890 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 895 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 247 | $2.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 375 | $285K |
| Vision | VISION SERVICE PLAN | 293 | $44K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 890 | $78K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 86 | $17K |
| Prescription drug(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 247 | $2.3M |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 890 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 890 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.