| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL R. SAUCEDO3 | 5409 E OLETA STREET LONG BEACH, CA 90815 | AMERICAN FIDELITY ASSURANCE COMPANY | $49K | — | $49K | 12.88% |
| SCOTT F. DURRETT3 Filed as: SCOTT F DURRETT | 2029 CENTURY PARK E., SUITE 2550 LOS ANGELES, CA 90067 | AMERICAN FIDELITY ASSURANCE COMPANY | $17K | — | $17K | 4.55% |
| FAITH A. BRATLIE3 | 1751 NEW ST NE CONYERS, GA 30012 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.54% |
| AMERICAN FIDELITY GENERAL AGENCY3 | 9000 CAMERON PKWY OKLAHOMA CITY, OK 73114 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.77% |
| SCOTT F. DURRETT3 Filed as: SCOTT F DURRETT | 2029 CENTURY PARK E., SUITE 2550 LOS ANGELES, CA 90067 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SHAW YODER ANTWIH SCHMELZER & LANGE EIN 94-2703086 THIRD PARTY ADMINISTRATOR | Participant communication; Named fiduciary; Account maintenance fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Plan Administrator Service code 10 | 1415 L STREET, SUITE 1000 SACRAMENTO, CA 95814 | $30K |
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 | 299 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 184 | $29K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 292 | $380K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 292 | $380K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 292 | $380K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.