| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARY R SIMS3 | 7840 EL CAJON BLVD SUITE #303 LA MESA, CA 91941 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | $30K | — | $30K | 3.70% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST SUITE 234 PHOENIX, AZ 85018 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | $7K | — | $7K | 0.92% |
| GARY SIMS3 Filed as: GARY ROBERT SIMS | 7840 EL CAJON BLVD STE 303 LA MESA, CA 91942 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.78% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 165 | $810K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $73K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 165 | $810K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.