| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS | 2505 EASTVIEW DRIVE CASTLE ROCK, CO 80104 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 2.11% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 2.11% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 1.12% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | 18022 COWAN STREET, SUITE 225 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $920 | — | $920 | 4.41% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $920 | — | $920 | 4.41% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $736 | — | $736 | 3.53% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | PRINCIPAL LIFE INSURANCE COMPANY | $521 | — | $521 | 2.50% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | 18022 COWAN, SUITE 225 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $346 | — | $346 | 5.23% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $346 | — | $346 | 5.23% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNION SECURITY INSURANCE COMPANY | $301 | — | $301 | 4.55% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | HARTFORD LIFE AND ACCIDENT | $220 | — | $220 | 5.31% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | HARTFORD LIFE AND ACCIDENT | $201 | — | $201 | 4.85% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | P.O. BOX 15750 IRVINCE, CA 92623 | HARTFORD LIFE AND ACCIDENT | $201 | — | $201 | 4.85% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | 18022 COWAN, SUITE 225 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $415 | — | $415 | 10.79% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $415 | — | $415 | 10.79% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNION SECURITY INSURANCE COMPANY | $323 | — | $323 | 8.40% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | 18022 COWAN STREET, SUITE 225 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $160 | — | $160 | 4.41% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $160 | — | $160 | 4.41% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $160 | — | $160 | 4.41% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | PRINCIPAL LIFE INSURANCE COMPANY | $85 | — | $85 | 2.34% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | 18022 COWAN, SUITE 225 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $296 | — | $296 | 10.41% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $296 | — | $296 | 10.41% |
| CENTENIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNION SECURITY INSURANCE COMPANY | $262 | — | $262 | 9.21% |
| GREGORY EUGENE LOCY3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 4.92% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INSURANCE ADVOCATES INC. | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 1.99% |
| ANDRREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.53% |
| ALLEN MAIRS3 | P.O. BOX 696 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.47% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS | P.O. BOX 15750 IRVINE, CA 92623 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.35% |
| BRUCE W BUSSER3 Filed as: BRUCE W. BUSSER | 22461 SAN JOAQUIN DRIVE WEST CANYON LAKE, CA 92587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.29% |
| ROGER STUART KENCHEL3 | 2588 EL CAMINO REAL CARLSBAD, CA 92008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.23% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R&B ENROLLMENT SERVICES INC. | P.O. BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.06% |
| EMPLOYER CONCEPTS INS. SERVICES3 Filed as: EMPLOYER CONCEPTS INSURANCE SVCS. | 18022 COWAN, SUITE 225 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $181 | — | $181 | 11.14% |
| LPCH INSURANCE SERVICES INC.3 | 3781 CLAREMONT STREET IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $181 | — | $181 | 11.14% |
| CENTENNIAL GROUP BENEFITS3 | P.O. BOX 3387 SEAL BEACH, CA 90740 | UNION SECURITY INSURANCE COMPANY | $127 | — | $127 | 7.82% |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 99 | $401K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 34 | $21K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 44 | $4K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 20 | $8K |
| Short-term disability(3 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 15 | $8K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 102 | $4K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 99 | $401K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 12 | $3K |
| 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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.