| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF COLORADO, LLC | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | BLUE CROSS OF CALIFORNIA | $27K | $0 | $27K | 2.22% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF CALIFORNIA INS | 1300 DOVE STREET, SUITE 300 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $22K | $0 | $22K | 1.81% |
| COMMERCIAL INSURANCE ASSOCIATES3 | 103 POWELL STREET, SUITE 200 BRENTWOOD, TN 37027 | BLUE CROSS OF CALIFORNIA | $15K | $0 | $15K | 1.28% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NL, LLC | 435 WHITTINGTON PARKWAY, SUITE 300 LOUISVILLE, KY 40222 | BLUE CROSS OF CALIFORNIA | $0 | $722 | $722 | 0.06% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS CAPITAL, INC. | 196 SOUTH FIR STREET VENTURA, CA 93001 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 3.44% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF COLORADO, LLC | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.34% |
| COMMERCIAL INSURANCE ASSOC., LLC3 Filed as: COMMERCIAL INSURANCE ASSOC, LLC | 103 POWELL COURT, SUITE 200 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.35% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2 ENTERPRISE DRIVE, SUITE 204 SHELTON, CT 06484 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF COLORADO, LLC | 4582 SOUTH ULSTER STREET, SUITE 600 DENVER, CO 80237 | SUN LIFE ASSURANCE COMPANY OF CANADA | $279 | $0 | $279 | — |
| COMMERCIAL INSURANCE ASSOC., LLC3 Filed as: COMMERCIAL INSURANCE ASSOC, LLC | 103 POWELL COURT, SUITE 100 BRENTWOOD, TN 37027 | SUN LIFE ASSURANCE COMPANY OF CANADA | $160 | $0 | $160 | — |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 171 | $1.3M |
| Dental | BLUE CROSS OF CALIFORNIA | 171 | $1.2M |
| Vision | BLUE CROSS OF CALIFORNIA | 171 | $1.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $58K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $58K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $58K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 16 | $86K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.