| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | — | $3K | $3K | 5.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 S. PARKER STEET, 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $1K | — | $1K | 2.09% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC. | $296 | — | $296 | 6.25% |
| INNOVATIVE COST MANAGEMENT SERVICES3 Filed as: INNOVATIVE COST MANAGEMENT | 95 S. MARKET STREET, SUITE 600 SAN JOSE, CA 95113 | PRINCIPAL LIFE INSURANCE COMPANY | $171 | — | $171 | 5.81% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN. | 721 PARKER STREET, SUITE 140 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | $71 | — | $71 | 2.41% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 102 | $57K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $3K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 102 | $57K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 125 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.