| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHCHOICES OF CA INS. SERVICES3 Filed as: HEALTHCHOICES OF CA INS SVCS | 1 PELICAN HILL CIRCLE NEWPORT COAST, CA 92657 | BLUE CROSS OF CALIFORNIA | $19K | $1K | $21K | 3.70% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | BLUE CROSS OF CALIFORNIA | $10K | — | $10K | 1.72% |
| HEALTHCHOICES OF CA INS. SERVICES3 Filed as: HEALTHCHOICES OF CA INS SVCS | 1 PELICAN HILL CIRCLE NEWPORT COAST, CA 92657 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 3.19% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $93 | $6K | 1.85% |
| HEALTHCHOICES OF CA INS. SERVICES3 Filed as: HEALTHCHOICES OF CA INS SVCS | 1 PELICAN HILL CIRCLE NEWPORT COAST, CA 92657 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | $75 | $1K | 3.70% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $505 | — | $505 | 1.72% |
| CONTINENAL AMERICAN - SEE ATTACHED3 | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 57.60% |
| HEALTHCHOICES OF CA INS. SERVICES3 Filed as: HEALTHCHOICES OF CA INS SVCS | 1 PELICAN HILL CIRCLE NEWPORT COAST, CA 92657 | ANTHEM LIFE INSURANCE COMPANY | $419 | $31 | $450 | 3.70% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | ANTHEM LIFE INSURANCE COMPANY | $210 | — | $210 | 1.73% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $53 | $2K | 27.05% |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 97 | $861K |
| Dental | BLUE CROSS OF CALIFORNIA | 97 | $561K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 196 | $29K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 196 | $36K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 47 | $19K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 47 | $12K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 97 | $861K |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 196 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.