| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE WOODLAND HILLS, CA 91367 | AETNA | $27K | — | $27K | 4.04% |
| CHARLES W. TAPERT INSURANCE AGENCY3 | 14 NORTH BALDWIN AVENUE SIERRA MADRE, CA 90124 | AETNA | $8K | — | $8K | 1.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | AETNA | -$98 | — | -$98 | -0.01% |
| CHARLES W. TAPERT INSURANCE AGENCY3 | 14 NORTH BALDWIN AVENUE SIERRA MADRE, CA 91024 | DELTACARE | $5K | — | $5K | 9.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND STREET, SUITE 600 GLENDALE, CA 91203 | DELTACARE | $560 | — | $560 | 0.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | VISION SERVICE PLAN | $97 | — | $97 | 0.97% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVENUE, 12TH FLOOR WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 14.63% |
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 | 41 | 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) | 41 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA | 93 | $658K |
| Dental | DELTACARE | 97 | $59K |
| Vision | VISION SERVICE PLAN | 64 | $10K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $7K |
| Prescription drug | AETNA | 93 | $658K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 100 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.