| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE COMPANY | $67K | — | $67K | 3.68% |
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $5K | 4.73% |
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $2K | — | $2K | 4.04% |
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $657 | $6K | 14.23% |
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | RELIASTAR INSURANCE COMPANY | $5K | — | $5K | 19.22% |
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC. | $986 | $92 | $1K | 13.17% |
| INTEGRO INSURANCE BROKERS3 | 3620 BIRCH STREET NEWPORT BEACH, CA 92660 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $914 | — | $914 | 15.01% |
| AXA ASSISTANCE, USA5 | 122 S MICHIGAN AVE., SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $18 | $18 | 0.30% |
| AXA ASSISTANCE, USA5 | 122 S MICHIGAN AVENUE, SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5 | $5 | — |
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 | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 393 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 344 | $1.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 601 | $123K |
| Vision | VISION SERVICE PLAN | 238 | $41K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 391 | $39K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 391 | $39K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 344 | $1.8M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 391 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 601 | — |
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."
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.