| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICE | $11K | $27K | $38K | 2.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS SERVICE | $6K | $13K | $19K | 1.28% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN | $17K | $0 | $17K | 2.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN | $5K | $0 | $5K | 0.72% |
| JOHN M. GILMORE, INC.3 | 200 SOUTH LOS ROBLES, SUITE 200 PASADENA, CA 91101 | TRANSAMERICA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 8.87% |
| TELLUS BROKERAGE CONNECTIONS3 Filed as: TELLUS BROKERAGE CONNECTIONS, INC. | 4315 NORTH FRONT STREET HARRISBURG, PA 17110 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.59% |
| ADVANCED LTC INSURANCE SERVICES3 | 520 EAST WILSON AVENUE, SUITE 210 GLENDALE, CA 91206 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.62% |
| LEISURE WERDEN & TERRY AGENCY3 Filed as: LEISURE WERDEN AND TERRY AGENCY | 200 SOUTH LOS ROBLES, SUITE 435 PASADENA, CA 91101 | TRANSAMERICA LIFE INSURANCE COMPANY | $807 | $0 | $807 | 1.13% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.47% |
| BENEFITS AMERICA INS. SVCS., LLC3 Filed as: BENEFITS AMERICA INS. SERVICES, LLC | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $213 | $0 | $213 | 0.36% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $32 | $32 | — |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $3 | $3 | — |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 229 | $2.2M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 229 | $1.4M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 229 | $1.4M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 156 | $60K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 156 | $60K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 156 | $60K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN | 102 | $707K |
| Other(3 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 160 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
No prospect flags tripped on this filing.