Plan Ledger DOL Form 5500 · updated monthly

Pacific Haven Subacute and Healthcare Centerbenefits

Pacific Haven and Companion Health & Welfare Plan · COSTA MESA, CA · plan year 2023

Broker compensation reported · 2023
$52,539

Pacific Haven Subacute and Healthcare Center's benefits plan covered 59 active participants in 2023, providing health · life · dental · vision · short-term disability · long-term disability · death benefits. Insurance brokers and agents were paid $52,539 in commissions and fees, costs that ultimately come out of what the employer and employees pay for coverage. That is $890 per covered person, in the top 10% of employer plans that report broker pay.

Insurance contracts · 202310
BLUE CROSS BLUE SHIELD OF TEXAS · health drug hmo ppopremiums n/a · 16 covered
BLUE CROSS BLUE SHIELD OF ARIZONA · health drug hmo ppopremiums n/a · 10 covered
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA · dental visionpremiums n/a · 22 covered
AMERITAS LIFE INSURANCE CORPORATION · visionpremiums n/a · 37 covered
AFLAC · health dental life stdpremiums n/a · 4 covered
AFLAC · health dental life stdpremiums n/a · 2 covered
AFLAC · health dental life stdpremiums n/a · 7 covered
LIFE INSURANCE COMPANY OF NORTH AMERICA · life std ltdpremiums n/a · 18 covered
KAISER FOUNDATION HEALTH PLAN, INC. · health drug hmopremiums n/a · 87 covered
DELTA DENTAL OF CALIFORNIA · dentalpremiums n/a · 99 covered
Brokers & agents paid · 20236
GALLAGHER BENEFIT SERVICES, INC.$18,936 · incl $628 fees
SPECTRUM RISK MGMT. AND INS. SVCS.$32,474
DAVID STEINBERG AND VARIOUS AGENTS$140
SCOTT W BLACKSHEAR AND OTHER AGENTS$47
RICHARD K. FORCONI AND OTHER AGENTS$24
13 individual agents · names withheld$918

Individual agents paid under $1,000 on this filing are shown as a total. The amounts are as filed; only the personal names are withheld.

Also brokered by Gallagher5
Prisma Health SC$6,161,180

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Source: DOL Form 5500 Schedule A, plan year 2023, EIN 330492281 · Verify on EFAST2 · Amounts are as reported by the plan sponsor.