| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TCIG PACIFIC INSURANCE SERVICES3 Filed as: TCIG INSURANCE SERVICES, INC. | 2801 TOWNSGATE ROAD SUITE 310 WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $184K | — | $184K | 5.05% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCIAL | 4851 LBJ FREEWAY #1100 DALLAS, TX 75244 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $74K | $74K | 2.02% |
| TCIG PACIFIC INSURANCE SERVICES3 Filed as: TCIG INSURANCE SERVICES, INC. | 2801 TOWNSGATE ROAD SUITE 310 WESTLAKE VILLAGE, CA 91361 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 3.12% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $72 | $72 | 0.03% |
| TCIG PACIFIC INSURANCE SERVICES3 Filed as: TCIG INSURANCE SERVICES, INC. | 2801 TOWNSGATE ROAD #310 WESTLAKE VILLAGE, CA 91361 | GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 33.70% |
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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 208 | $3.6M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 222 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 175 | $259K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 175 | $259K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 175 | $259K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.