| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NTH INSURANCE AGENCY INC.3 Filed as: NTH INSURANCE AGENCY INC | 10833 VALLEY VIEW ST STE 550 CYPRESS, CA 90630 | UNITEDHEALTHCARE INSURANCE COMPANY | $51K | $0 | $51K | 4.83% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNITEDHEALTHCARE INSURANCE COMPANY | $21K | $0 | $21K | 1.99% |
| PAUL CURTIS ACHEE3 | 402 W OJAI AVE STE 208 OJAI, CA 93023 | UNITEDHEALTHCARE INSURANCE COMPANY | -$194 | $0 | -$194 | -0.02% |
| NTH INSURANCE AGENCY INC.3 Filed as: NTH INSURANCE AGENCY | 10833 VALLEY VIEW ST STE 550 CYPRESS, CA 90630 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $0 | $12K | 4.92% |
| PAUL CURTIS ACHEE3 | 226 W OJAI AVE STE 114 OJAI, CA 93023 | KAISER FOUNDATION HEALTH PLAN INC | -$121 | $0 | -$121 | -0.05% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.3M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.1M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.1M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.1M |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.1M |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 379 | — |
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.