| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HRIS INSURANCE SERVICES3 | 15840 VENTURA BLVD. SUITE 205 ENCINO, CA 91436 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | — | $12K | 1.75% |
| LOCKTON COMPANIES, LLC3 | 725 S. FIGUEROA STREET 35TH FLOOR LOS ANGELLES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | — | $12K | 1.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.98% |
| HRIS INSURANCE SERVICES3 | 15840 VENTURA BLVD. SUITE 205 ENCINO, CA 91436 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 1.84% |
| LOCKTON COMPANIES, LLC3 | 725 FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 1.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 0.97% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 725 S. FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $4K | $14K | 9.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.44% |
| HRIS INSURANCE SERVICES3 | 15840 VENTURA BLVD. SUITE 205 ENCINO, CA 91436 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.01% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 82 | $964K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $146K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $146K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $146K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 82 | $964K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 141 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.