| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $11K | $13K | $24K | 1.77% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $18K | — | $18K | 15.07% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 EAST UNION AVENUE DENVER, CO 80237 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | — | $207 | $207 | 0.17% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $2K | $6K | 6.63% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8100 EAST UNION AVENUE DENVER, CO 80237 | METROPOLITAN LIFE INSURANCE COMPANY | — | $159 | $159 | 0.17% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $380 | — | $380 | 2.04% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | P.O. BOX 173850 DENVER, CO 80217 | VISION SERVICE PLAN | $2 | — | $2 | 0.01% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC. | $848 | $82 | $930 | 8.99% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 EAST UNION AVENUE DENVER, CO 80237 | SAFEGUARD HEALTH PLANS, INC. | $31 | $14 | $45 | 0.43% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.4M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 300 | $106K |
| Vision | VISION SERVICE PLAN | 158 | $19K |
| Life insurance | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 206 | $123K |
| Short-term disability | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 206 | $123K |
| Long-term disability | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 206 | $123K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.4M |
| Other | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 206 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.