| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $1K | $15K | 11.14% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MELTZER GROUP, INC. | 6500 ROCK SPRING DRIVE, SUITE 500 BETHESDA, MD 20817 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $439 | $439 | 0.32% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 7.15% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 6.56% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.00% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS, INC. | 333 INDIAN HILL BOULEVARD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23 | — | $23 | 0.07% |
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 | 21 | 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) | 21 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 5 | $120K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 21 | $93K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 5 | $59K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3 | $135K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3 | $135K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3 | $135K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 5 | $59K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21 | — |
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.