| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS, INC | 4812 BROWNDEER LN. RANCHO PALOS VERDES, CA 90275 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 4.91% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS, INC | 4812 BROWNDEER LANE RANCHO PALOS VERDES, CA 90275 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 4.91% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS INC. | 655 DEEP VALLEY DRIVE SUITE 325A ROLLING HILLS ESTATES, CA 902743615 | AMERITAS LIFE INSURANCE CORP. | $4K | $98 | $4K | 10.27% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS | 27520 HAWTHORNE BLVD. SUITE 100 ROLLING HILLS ESTATE, CA 90274 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 13.56% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS | 27520 HAWTHORNE BLVD. SUITE 100 ROLLING HILLS ESTATES, CA 90274 | LIBERTY DENTAL PLAN OF CALIFORNIA, INC. | $806 | — | $806 | 8.88% |
| SHANIKA M. FISKE3 | 15 TUOLUMNE WAY ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $250 | $85 | $335 | 7.52% |
| MONTE TENEYCK3 | 185 PENDLETON LANE TENPLETON, CA 93465 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $222 | — | $222 | 4.98% |
| CONSUMER DRIVEN BENEFITS LLC3 | 3737 BIRCH ST. NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | $46 | $113 | 2.54% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN. ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $19 | $88 | 1.97% |
| INTEGRATED BENEFIT CONSULTANTS INC3 Filed as: INTEGRATED BENEFIT CONSULTANTS | 27520 HAWTHORNE BLVD. ROLLING HILLS ESTATES, CA 90274 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 1.73% |
| WILLIAM SCOTT BURGER3 | 7 LAS BALAS RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 1.12% |
| VALOR BENEFITS3 | 12125 KOUDEKERK ST. ARTESIA, CA 90701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.11% |
| RACHAEL DARLENE DUBE3 | 1 PEBBLEWOOD IRVINE, CA 92604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.09% |
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 | 113 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 140 | $509K |
| Dental(3 contracts, 3 carriers) | AMERITAS LIFE INSURANCE CORP. | 212 | $65K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 212 | $56K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $19K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 2 | $4K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 212 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.