| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1 S. LOS CARNEROS ROAD GOLETA, CA 93117 | BLUE CROSS OF CALIFORNIA | $14K | $179 | $15K | 2.15% |
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $14K | $14K | 2.02% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $12K | $1K | $13K | 1.90% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 2280 WARDLOW CIRCLE CORONA, CA 92880 | BLUE CROSS OF CALIFORNIA | $12K | — | $12K | 1.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | STANDARD INSURANCE COMPANY | $717 | — | $717 | 3.31% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | STANDARD INSURANCE COMPANY | $332 | — | $332 | 1.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | STANDARD INSURANCE COMPANY | $10K | $696 | $10K | 61.73% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | STANDARD INSURANCE COMPANY | $659 | — | $659 | 3.94% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 9.15% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | STANDARD INSURANCE COMPANY | $873 | — | $873 | 5.36% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 COSTA MESA, CA 92626 | MEDIEXCEL HEALTH PLAN | $222 | — | $222 | 2.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, SC 92806 | MEDIEXCEL HEALTH PLAN | $152 | — | $152 | 1.88% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | STANDARD INSURANCE COMPANY | $182 | — | $182 | 2.62% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | STANDARD INSURANCE COMPANY | $110 | — | $110 | 1.58% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | STANDARD INSURANCE COMPANY | $413 | — | $413 | 6.22% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | STANDARD INSURANCE COMPANY | $349 | — | $349 | 5.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | STANDARD INSURANCE COMPANY | $310 | $222 | $532 | 11.90% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | STANDARD INSURANCE COMPANY | $237 | — | $237 | 5.30% |
| ACRISURE LLC3 Filed as: ORION RISK MANAGEMENT | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | ARAG INSURANCE COMPANY | $249 | — | $249 | 7.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2401 E. KATELLA AVENUE ANAHEIM, CA 92806 | ARAG INSURANCE COMPANY | $106 | — | $106 | 2.98% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 144 | $684K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 144 | $698K |
| Vision | STANDARD INSURANCE COMPANY | 63 | $7K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 144 | $683K |
| Short-term disability | STANDARD INSURANCE COMPANY | 31 | $4K |
| Long-term disability | STANDARD INSURANCE COMPANY | 46 | $16K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 144 | $676K |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 144 | $680K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.