| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | $21K | $200K | $221K | 3.36% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | CALIFORNIA PHYSICIANS SERVICE | $7K | $63K | $71K | 1.07% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $166K | $12K | $177K | 30.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30K | $3K | $33K | 5.56% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON, LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.49% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY FINANCIAL STRATAGIES | 1936 E DEERE AVE. SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.01% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $108K | $9K | $118K | 23.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CT 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $3K | $21K | 4.20% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY FINANCIAL STRATAGIES | 1936 E DEERE AVE. SANTA ANA, CA 92705 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.30% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON, LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $146 | — | $146 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $7K | — | $7K | 6.81% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $2K | — | $2K | 2.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $610 | $7K | 13.43% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 111 CORPORATE DRIVE LADERA RANCH, CA 92694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.68% |
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 | 1,768 | 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) | 1,768 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 572 | $6.6M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 572 | $6.6M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 572 | $6.6M |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,768 | $745K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,768 | $592K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 572 | $6.6M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,629 | $677K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,629 | — |
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.