| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | CALIFORNIA PHYSICIANS SERVICE | $57K | $824 | $58K | 5.07% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $20K | — | $20K | 2.59% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $9K | $19K | 6.74% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | TUFTS INSURANCE COMPANY | $7K | — | $7K | 2.55% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.48% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 19.98% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 19.68% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $647 | $3K | 19.55% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BARNEY & BARNEY | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| GERALD W. NANNEN4 Filed as: GERALD W NANNEN | 264 NORTH MAIN STREET EAST LONGMEADOW, MA 01028 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $602 | — | $602 | 14.69% |
| JESSE RAMOS4 | 7331 SHELBY LANE, #23 RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $494 | — | $494 | 12.05% |
| DAVID J MCCLELLAN4 Filed as: DAVID E PAPERNO | 78347 GRAPE ARBOR AVENUE PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $162 | — | $162 | 3.95% |
| LINDA E. BOWDEN4 Filed as: LINDA E BOWDEN | 1334 E CHANDLER BLVD, SUITE D-73 PHOENIX, AZ 85048 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $58 | — | $58 | 1.41% |
| ROBERT MAVERICK4 | 15221 MARLIN PLACE VAN NUYS, CA 91405 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $15 | — | $15 | 0.37% |
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 | 329 | 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) | 331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 246 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 257 | $284K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 257 | $284K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 326 | $38K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 202 | $38K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 326 | $41K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 139 | $1.1M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 326 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.