| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE FLOOR 14 ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $13K | — | $13K | 3.01% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | BLUE CROSS OF CALIFORNIA | — | $8K | $8K | 1.81% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1420 5TH AVENUE SUITE 1500 SEATTLE, WA 98101 | BLUE CROSS OF CALIFORNIA | $3K | — | $3K | 0.62% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 320 W 57TH ST FL 3 NEW YORK, NY 10019 | VISION SERVICE PLAN | $712 | — | $712 | 3.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $214 | — | $214 | 1.13% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B ST FL 6 SAN DIEGO, CA 92101 | VISION SERVICE PLAN | $141 | — | $141 | 0.75% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 100 PINE ST 11TH FLOOR SAN FRANCISCO, CA 94111 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $16K | — | $16K | 335.26% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES I | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $8K | $8K | 167.63% |
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 | 101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS OF CALIFORNIA | 78 | $735K |
| Vision | VISION SERVICE PLAN | 98 | $19K |
| Life insurance(2 contracts) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 102 | $11K |
| Short-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 102 | $11K |
| Long-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 102 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 102 | — |
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.