| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | 130 THEORY SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $21K | — | $21K | 3.16% |
| MCGRIFF INSURANCE SERVICES INC3 | 130 THEORY SUITE 200 IRVINE, CA 926173065 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 3.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | 130 THEORY STE 200 IRVINE, CA 926173065 | AMERITAS LIFE INSURANCE CORP. | $8K | — | $8K | 4.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 130 THEORY STREET #200 IRVINE, CA 92660 | GUARDIAN | $5K | $657 | $6K | 11.34% |
| JULIE S KRAUS3 | 15066 VARSITY STREET APT B MOORPARK, CA 93021 | AFLAC | $2K | $64 | $2K | 10.85% |
| CN BENEFITS INC3 | 4011 SAN LUIS ST NEWBURY PARK, CA 91320 | AFLAC | $334 | $12 | $346 | 1.62% |
| BRADLEY IAN WITT3 | 1621 RIDGEWOOD DR CAMARILLO, CA 93012 | AFLAC | $281 | $12 | $293 | 1.37% |
| AMY SLOKAN3 Filed as: AMY LEE SLOKAN | 4326 CAMPSITE LOOP ORLANDO, FL 32824 | AFLAC | $194 | — | $194 | 0.91% |
| MICHAEL S NOLAN3 | 2551 GALENA AVE UNIT 1776 SIMI VALLEY, CA 93062 | AFLAC | $113 | — | $113 | 0.53% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS INC | 2905 MAGNOLIA AVE LONG BEACH, CA 90806 | AFLAC | $56 | — | $56 | 0.26% |
| DEVITA MCKENZIE3 Filed as: DEVITA B MCKENZIE | 1139 IROLO STREET LOS ANGELES, CA 90006 | AFLAC | $48 | — | $48 | 0.22% |
| MARY LOU GRAHAM3 | 1747 OFELIA WAY OXNARD, CA 93030 | AFLAC | $46 | — | $46 | 0.22% |
| GENA G QUARANTELLO3 | 12962 E VISTAPARK DR MOORPARK, CA 93021 | AFLAC | $37 | — | $37 | 0.17% |
| D BREDESON INSURANCE SERVICES INC3 | 19043 META RD CORNELIUS, NC 28031 | AFLAC | $24 | — | $24 | 0.11% |
| RICHARD J KUNZ3 | 601 MONTGOMERY ST STE 1475 SAN FRANCISCO, CA 94111 | AFLAC | $12 | — | $12 | 0.06% |
| JOSEPH RAY HARDIE3 | 909 E PLAYA DEL NORTE DR APT 6011 TEMPE, AZ 85288 | AFLAC | $11 | — | $11 | 0.05% |
| DUANE A ADAMS3 Filed as: DUANE ANDREW FRY | 641 HIGUERA ST STE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $7 | — | $7 | 0.03% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $6 | — | $6 | 0.03% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $6 | — | $6 | 0.03% |
| GENA GRACE QUARANTELLO3 | 12962 E VISTAPARK DRIVE MOORPARK, CA 93021 | AFLAC | $4 | — | $4 | 0.02% |
| SHANE M OWEN3 Filed as: SHANE CRAIG DAVISON | 3013 LARGE HOP LN ANTIOCH, TN 37013 | AFLAC | $4 | — | $4 | 0.02% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 5753 HIGHWAY 85 N PMB 8179 CRESTVIEW, FL 32536 | AFLAC | $3 | — | $3 | 0.01% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH BUZZELLO | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $3 | — | $3 | 0.01% |
| CHARLES D. BLOCK3 Filed as: CHARLES B CAREY | 16215 LYLE ST SAN LEANDRO, CA 94578 | AFLAC | $2 | — | $2 | 0.01% |
| PETER C. FOY & ASSOCIATES3 Filed as: PETER LYMAN SR | 8 S VOLUNTARIO ST UNIT A SANTA BARBARA, CA 93103 | AFLAC | $2 | — | $2 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | 3475 E FOOTHILL BL., #100 PASADENA, CA 91107 | FEDERAL INSURANCE COMPANY | $232 | — | $232 | 15.47% |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 87 | $1.1M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 330 | $208K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 330 | $208K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 155 | $50K |
| Short-term disability | GUARDIAN | 161 | $49K |
| Long-term disability | GUARDIAN | 161 | $49K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 87 | $1.1M |
| Other(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 178 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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.