| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PHILLIPS PACIFIC INSURANCE SERVICES3 Filed as: PHILLIPS PACIFIC | INSURANCE SERVICES INC 29800 AGOURA RD STE 203 AGOURA HILLS, CA 91301 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $154K | — | $154K | 4.87% |
| AMWINS3 Filed as: AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN STREET STE 800 SANTA ANA, CA 92705 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $62K | $62K | 1.95% |
| PHILLIPS PACIFIC INSURANCE SERVICES3 Filed as: PHILLIPS PACIFIC INSURANCE | SERVICES 31200 VIA COLINAS #103 THOUSAND OAKS, CA 91362 | HARTFORD LIFE AND ACCIDENT | $26K | — | $26K | 11.35% |
| PHILLIPS PACIFIC INSURANCE SERVICES3 Filed as: PHILLIPS PACIFIC INSURANCE | SERVICES, INC 31200 VIA COLINAS, #103 WESTLAKE VILLAGE, CA 91362 | FOUR EVER LIFE INS CO | $11K | — | $11K | 8.00% |
| PHILLIPS PACIFIC INSURANCE SERVICES3 Filed as: PHILLIPS PACIFIC INSURANCE SER | 31200 VIA COLINAS 103 WESTLAKE VILLAGE, CA 91362 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 17.64% |
| PHILLIPS PACIFIC INSURANCE SERVICES3 Filed as: PHILLIPS PACIFIC INSURANCE | SERVICES, INC 31200 VIA COLINAS STE 103 WESTLAKE VILLAGE, CA 91362 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 14.04% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 308 | $3.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 129 | $44K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 129 | $44K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 139 | $226K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 139 | $226K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 139 | $244K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 308 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 308 | — |
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.