| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | AETNA LIFE INSURANCE COMPANY | $298K | $0 | $298K | 3.16% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $7K | $32K | 8.17% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $215 | $0 | $215 | 0.05% |
| B2 INSURANCE SERVICES3 Filed as: DB INSURANCE SERVICES INC | 1426 AVIATION BOULEVARD REDONDO BEACH, CA 90278 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3 | $0 | $3 | 0.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $114 | $0 | $114 | 3.52% |
| B2 INSURANCE SERVICES3 Filed as: DB INSURANCE SERVICES INC | 1426 AVIATION BOULEVARD REDONDO BEACH, CA 90278 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 1.51% |
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 | 1,114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 60 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 2,880 | $9.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 2,880 | $9.4M |
| Vision | AETNA LIFE INSURANCE COMPANY | 2,880 | $9.4M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 923 | $395K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 923 | $392K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 923 | $392K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 2,880 | $9.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 923 | $392K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,880 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.