| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $34K | — | $34K | 5.46% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 3.96% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | — | $18K | 5.43% |
| BENEFITS EXCHANGE ALLIANCE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | VISION SERVICE PLAN | $5K | — | $5K | 7.74% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $6K | 12.03% |
| BENEFITS EXCHANGE ALLIANCE3 | 3744 MT. DIABLO BLVD. LAYFAYETTE, CA 94549 | AETNA HEALTH, INC. | $3K | $13K | $16K | 34.40% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 11.44% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 12.02% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 10.59% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $779 | $949 | $2K | 11.09% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $479 | $672 | $1K | 12.03% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METLIFE LEGAL PLANS | $766 | — | $766 | 9.28% |
| ADSH INVESTMENTS3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | MUTUAL OF OMAHA INSURANCE COMPANY | $348 | $416 | $764 | 10.98% |
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 | 1,006 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,009 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 391 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 472 | $359K |
| Vision | VISION SERVICE PLAN | 379 | $66K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,006 | $83K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $21K |
| Prescription drug(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 391 | $3.0M |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,006 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,006 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.